Front Cover
 Front Matter
 Title Page
 Table of Contents
 The Florida plan
 Administration and supervision...
 Teacher qualifications
 Records and reports
 Coordination of public agency...
 Children with speech irregular...
 Children with hearing loss
 Children with partial vision
 Children with crippling condit...
 Children with special health...
 Children who learn slowly
 Home-school cooperation

Group Title: Bulletin - State Department of Education ; 55
Title: Developing a program for education of exceptional children in Florida
Full Citation
Permanent Link: http://ufdc.ufl.edu/UF00067275/00001
 Material Information
Title: Developing a program for education of exceptional children in Florida
Series Title: Its Bulletin
Physical Description: x, 136 p. : illus. ; 23 cm.
Language: English
Creator: Florida -- State Dept. of Education
Publisher: s.n.
Place of Publication: Tallahassee
Publication Date: 1948
Subject: Special education -- Florida   ( lcsh )
Education -- Florida   ( lcsh )
Genre: bibliography   ( marcgt )
non-fiction   ( marcgt )
Bibliography: Includes bibliographical references.
Funding: Bulletin (Florida. State Dept. of Education) ;
 Record Information
Bibliographic ID: UF00067275
Volume ID: VID00001
Source Institution: University of Florida
Rights Management: All rights reserved by the source institution and holding location.
Resource Identifier: oclc - 01731270
lccn - 50063006

Table of Contents
    Front Cover
        Front cover
    Front Matter
    Title Page
        Page i
        Page ii
    Table of Contents
        Page iii
        Page iv
        Page v
        Page vi
        Page vii
        Page viii
        Page ix
        Page x
    The Florida plan
        Page 1
        Page 2
        Page 3
        Page 4
        Page 5
        Page 6
        Page 7
    Administration and supervision in the local unit
        Page 8
        Page 9
        Page 10
        Page 11
    Teacher qualifications
        Page 12
        Page 13
        Page 14
    Records and reports
        Page 15
        Page 16
        Page 17
        Page 18
        Page 19
        Page 20
        Page 21
        Page 22
    Coordination of public agency services
        Page 23
        Page 24
        Page 25
        Page 26
        Page 27
        Page 28
        Page 29
        Page 30
        Page 31
        Page 32
    Children with speech irregularities
        Page 33
        Page 34
        Page 35
        Page 36
        Page 37
        Page 38
        Page 39
        Page 40
        Page 41
        Page 42
        Page 43
        Page 44
        Page 45
        Page 46
        Page 47
        Page 48
    Children with hearing loss
        Page 49
        Page 50
        Page 51
        Page 52
        Page 53
        Page 54
        Page 55
        Page 56
        Page 57
        Page 58
        Page 59
        Page 60
    Children with partial vision
        Page 61
        Page 62
        Page 63
        Page 64
        Page 65
        Page 66
        Page 67
        Page 68
        Page 69
        Page 70
        Page 71
        Page 72
    Children with crippling conditions
        Page 73
        Page 74
        Page 75
        Page 76
        Page 77
        Page 78
        Page 79
        Page 80
        Page 81
        Page 82
        Page 83
        Page 84
        Page 85
    Children with special health problems
        Page 86
        Page 87
        Page 88
        Page 89
        Page 90
        Page 91
        Page 92
        Page 93
        Page 94
    Children who learn slowly
        Page 95
        Page 96
        Page 97
        Page 98
        Page 99
        Page 100
        Page 101
        Page 102
        Page 103
        Page 104
        Page 105
        Page 106
    Home-school cooperation
        Page 107
        Page 108
        Page 109
        Page 110
        Page 111
        Page 112
        Page 113
        Page 114
        Page 115
        Page 116
        Page 117
        Page 118
        Page 119
        Page 120
        Page 121
        Page 122
        Page 123
        Page 124
        Page 125
        Page 126
        Page 127
        Page 128
        Page 129
        Page 130
        Page 131
        Page 132
        Page 133
        Page 134
        Page 135
        Page 136
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Developing a Program

jI" Cdacaio#n ofa


Bulletin No. 55
COLIN ENGLISH, Superintendent-Tallahassee, Fla.

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flr~c' 55

Foreword .......----.....-.----.... .............------ ------- ---- v
Acknowledgments __------------------------ viii
I. The Florida Plan ----------------. -------------- 1
II. Administration and Supervision in the Local Unit -- 8
III. Teacher Qualifications ....---- ---------------. 12
IV. Records and Reports ----------- 15
V. Coordination of Public Agency Services .------- 23
VI. The Areas:
1. Children with Speech Irregularities------- 33
2. Children with Hearing Losses -- __---- 49
3. Children with Partial Vision .___.---------- 61
4. Children with Crippling Conditions ---- 73
5. Children with Special Health Problems ----- 86
6. Children who Learn Slowly ---. .__--_ 95
VII. Home-School Cooperation -.------ 107
VIII. Evaluation ----... .......---------------- 111

Section 1. Extracts of Florida School Code Relating
to the Education of Exceptional Children 113
Section 2. Florida State Board Regulations Relating
to the Education of Exceptional Children 115
Section 3. List of State Department of Education
Publications frequently needed by
School Personnel ---------- 118
Section 4. Case History Facts Outline ------ 122
Section 5. Record and Report Forms --------- 124
Section 6. Locations of District or County Offices
of Statewide Public Agencies and Ser-
vices in Florida _.-------.-------.._ 135


Which boy is the exceptional child? Equal educational opportunity
for all includes the exceptional child, who needs specialized methods,
-quipment, and, oftentimes, additional services. (The exceptional boy
in the picture above is preparing to catch the football).

For many years in Florida, with the exception of a
few cities, there has been insufficient provision for meet-
ing the problems and needs of children who deviate
widely from the average. While state residential schools
have been provided for children who were blind or deaf
and for some of the mentally deficient, those with less
severe hearing loss, with partial vision, irregularities of
speech, or crippling conditions, and others who were
slow-learning remained for the public day school to
The goal of providing equal opportunity for optimal
education for all children is today recognized and
accepted in a democratic society. At no time has there
been so great a public awareness as at the present of the
values to be derived from a functional education that
enables the individual to take his part as a self-sustain-
ing, self-respecting, law-abiding citizen. Toward realiza-
tion of this goal the State of Florida in 1947 amended the
Florida School Code covering general education and em-
bodied in it further legislation relating to exceptional
children. These 1947 amendments to previous laws passed
in 1941 and 1945 have clarified and extended provisions
of the Florida program of special education. The county
board of education is made responsible for providing
educational services and facilities under the general
direction of the State Department of Education. Under
the present law, state funds for exceptional children are
available to counties for provisions of instruction and
capital outlay in the same manner as for other phases of
the school program.
Florida has definitely embarked upon a program of
wisely providing for its exceptional children in their
developmental years so that they shall be properly ad-
justed to take their places in society. This program is
democratically, economically, and educationally to the
interest of the state.
The areas for the education of exceptional children
covered by Florida Law, namely, slow-learning, physi-

cally disabled, and socially maladjusted are in line with
those areas generally included in such programs over
the country. The socially maladjusted child has not
been discussed in this bulletin. As the Mental Hygiene
program of the State Board of Health develops, consid-
eration will be given to the socially maladjusted child's
educational needs. The gifted, who are also classified
with exceptional children by the U. S. Office of Educa-
tion, are today served in the elementary and secondary
classrooms in the general instructional program in
Types of services and techniques designed to meet the
needs of exceptional children should differ among the
various classifications recognized as comprising excep-
tional children, and also differ within each classification.
The number of such children and the extent of their
needs will vary also in respect to community differences.
Communities have varied economic and social opportun-
ties. Some have thinly scattered populations, some shift-
ing populations, and there are the areas of large popula-
tion. There are differences in racial groups. In a few
localities there are Indians, in others the foreign born,
and in some Negro. Every community, whatever its
characteristics, will have exceptional children in school
attendance and others at home who have never been able
to get to school.
School administrators and teachers are desirous of
information and guidance concerning the state's plan
for education of exceptional children and its implementa-
tion at the local level. This bulletin is designed to inter-
pret the state law and state regulations. It provides an
administrative guide to the program of special education
for exceptional children. No attempt has been made
to include specialized methods and techniques for teach-
ers of exceptional children, since the qualified teacher
will have special training. Attention is given to five
groups of exceptional children. Services for children
who are slow-learning, those who have partial vision,
hearing loss, corrective speech problems, crippling con-
ditions, and other special health problems will be dis-
cussed. Items covered are pupil problems and needs,

recommendations for individual pupil study as a basis for
enrollment, organization of "Instructional Units", and
other essentials in the program. This bulletin should
be helpful not only for administrators and teachers, but
informative to doctors, nurses, social workers, rehabilita-
tion workers, and others who are engaged in any way
with furthering the program.

L^-",i7 GLj

This publication, Developing a Program for Educa-
tion of Exceptional Children in Florida, was prepared
by groups of Florida educators during the spring and
summer of 1948. It will be recognized from the list of
participants that a program for exceptional children is
so broad in scope that it calls for consultation with many
workers from the general instructional program and
from related fields. The success of the program for the
individual child depends upon the degree to which there
is mutual dovetailing of information and mutual plan-
Appreciation is extended to the committee members
who prepared this bulletin and to the consultants who
directed their efforts. Membership of the committee
working in the corrective speech area was as follows:
Margaret McClellan, Mary Clare Regan, Jacksonville;
Clarice T. Brown, Ocala; Sheila Morrison, Gainesville.
Consultants to this group were Dr. C. Raymond Van
Dusen, Director Speech Department, University of
Miami, and Dr. Lester Hale, Director Speech and Hear-
ing Clinic, University of Florida, Gainesville.
The committee for studying the education of children
with hearing losses was composed of: Lucy Moore, St.
Augustine; Dorothea Morin, Tampa; Elizabeth Cham-
bless, Dorothy Cornet, Edna Bond, Portia Laughlin,
Marie Maddox, Helen Miller, Miami; Waldo Heber,
Jacksonville. Dr. Waymah Brasell, Associate Profes-
sor of Clinical Psychology, Florida State University
was the consultant in this field.
In the area of education of the partially seeing the
committee was as follows: Louise Pickle, Mary Mae
Wyman, Tallahassee; Exa T. Ellison, Pensacola; Mabel
C. Hilton, Fort Myers; Ruby M. Nowell, Edith Gage,
Tampa; Frances Penn, St. Petersburg; Estelle Riddle,
Graceville; Martha Carter, Cora Lee Thompson, Jack-
sonville; Mildred Kennedy, Bradenton. Appreciation is
expressed to Mrs. Winifred. Hathaway, Associate Direc-

tor of the National Society for the Prevention of Blind-
ness, Inc., New York City, for reviewing the script.
The committee working in the area of children with
crippling conditions and health problems included:
Gretchen Everhart, Pensacola; Marjorie Crick, West
Palm Beach; Eunice Davis, Jacksonville; Elizabeth
Walker, Sarasota; Frances Huggins, Jane Collette,
Hilda Flowers, Frances Grimaldi, Margaret Jones,
Eunice Kimbrough, Mabel Russel, Kathleen Sullivan,
Ethel Tate, Miami.
The committee for the area of the slow learning was
composed of: Thelma Godfrey, Viola Wilson, Hazel
Watkins, Helen Aycock, Hester Fisackerly, Mary Conley,
Pearl Lewis, Lucille Varnes, Zona Ruth Thomas, Edith
Rogero, Jacksonville; Evelyn Minarich, Belle Glade;
Jean Patrick, Tampa; Laura Sutter, Pauline Sapp,
Thelma Starbird, Harold Tomson, Joseph White, Miami.
Especial thanks are expressed to the following con-
sultants from the State Department of Education: Dora
Skipper, Advisor; Joe Hall, Administration and Teacher
Certification; James Graham, Administration State
Board Regulations; Sara Lou Hammond, Pre-school,
Elementary Education and Child Development; A. L.
Vergason, Secondary Education and Evaluation; E. B.
Henderson, Supervision, Elementary and Secondary;
D. E. Williams, Negro Education; J. K. Chapman,
Records and Reports; Louise Smith, Health Resources;
Eunah Holden, Teacher Recruitment; Mildred Swear-
ingen, Index to Bulletins; T. George Walker, Publica-
tion; William J. Hodges, James E. Garland, Illustra-
tions; Howard Jay Friedman, Form; Claud Andrews,
State Director, Vocational Rehabilitation.
Consultants from related public agencies include: Dr.
W. T. Sowder, State Health Officer, State Board '-f
Health, also Dr. Frances E. M. Read, Director, Bureau
of Maternal and Child Health Services, Dr. L. L. Parks,
Director, Field Technical Staff, Dr. George A. Dame,
Director, Bureau of Local Health Service, and Ruth
Mettinger, R. N., Director, Division of Public Healtl
Nursing; Dr. H. A. Sauberli, Director, Leon Count:

Health Unit; Dr. L. J. Graves, Acting Director, Florida
Crippled Children's Commission; Frances Davis, Super-
visor, Child Welfare Division, State Welfare Board; Dr.
C. J. Settles, President, Florida School for the Deaf and
Blind; Sylvia Carothers, Executive Secretary, Florida
Children's Commission.
Appreciation is expressed to the following members
of the Child Welfare Committee of the Florida Medical
Association for having reviewed the script: Dr. War-
ren W. Quillian, Chairman, Dr. Gunnard J. Antell, Coral
Gables; Dr. Egbert V. Anderson, Pensacola; Dr. Luther
W. Holloway, Jacksonville; Dr. M. A. Perez, Tampa.
Valuable assistance was given in advisory capacity to
this program by other members of the Association
including the following: Dr. Walter Hotchkiss, Dr.
Bernard Goodman, Miami Beach; Dr. Arthur Weiland,
Coral Gables; Dr. Edward H. Williams, Dr. Marion
Salley, Miami; Dr. S. B. Forbes, Tampa.
Grateful acknowledgment is also accorded to the mem-
bers and staff of the Exceptional Child Section of Lead-
ership Training Conference at Florida State University
during the 1948 summer session.
This study was coordinated by Mrs. Roberta Moore
Yoakley, Consultant, Education of Exceptional Children,
State Department of Education. Dr. Hugh Waskom,
Director of Psychological Clinic, Florida State Univer-
sity served as the consultant for general planning pur-
poses. Serving as out-of-state consultants were Dr.
Christine P. Ingram, Director of Special Education,
Rochester, New York; and Dr. Romaine Mackie, Spe-
cialist for the Physically Handicapped, U. S. Office of
Education, Washington, D. C. Appreciation is expressed
to Dr. Elise H. Martens, Chief, Exceptional Children
and Youth, U. S. Office of Education for reviewing the
STo the preceding and all others who have contri-
buted to the content of this report the State Department
of Education expresses its grateful appreciation.



Within the framework of the total Florida Program
of Instruction the State Department of Education has
set up a plan for exceptional children.
The term "exceptional child" as defined in the state
law means any educable child or youth who deviates
from the normal child physically, intellectually, socially,
or emotionally to such a degree that specialized or addi-
tional services are required to achieve for him educa-
tional goals comparable to those desirable for all chil-
These are, for example, children whose limited hear-
ing keeps them from understanding much that is going
on around them, children whose speech problems keep
them from communicating ideas so they can be under-
stood by others, children who cannot with the best medi-
cal aid read the ordinary printed page and keep pace
with the visual demands of the school program, children
who have had irregular schooling or cannot get to school

The school program for exceptional children is formulated by both
school and cooperating personnel. Here. a school supervisor, health
officer, consulting psychologist, principal, teacher, welfare supervisor,
and public school nurse discuss an exceptional child program.


because of serious illness or severe crippling conditions,
such as cerebral palsy and infantile paralysis, and chil-
dren who are so intellectually retarded that they can-
not develop the concepts and understand the symbols of
the on-going grade curriculum. Without clinical study
and diagnosis, medical treatment, adjusted curriculum,
specialized methods, individual guidance, and special
equipment these children cannot achieve success in edu-
cation and in adjustment to daily life demands. While
exceptional children vary in their physical and intellec-
tual potentialities, each one is entitled to an education
that will enable him to make the happiest adjustment to
life and the most constructive contribution to society of
which he is capable.

A brief overview of the Florida Program of Instruc-
tion brings into focus current trends and goals in the
school program for all pupils. As a part of the total
program for the improvement of Florida Schools, the
State Department of Education over the last decade has
been engaged in developing curricula and instructional
procedures to meet the changing trends in the field of
education and of society. As the Florida program has
been developed and set forth in instructional bulletins'
there is emphasis on certain practices basic to optional
education for all children. These practices are:
-providing for all round child growth and
development, physical, mental, social, and
-recognizing maturation.
-knowing the child and keeping cumulative
pupil records from school entrance through
high school.

'See Florida Curriculum Bulletins No. 2, 9, 9-A, 10, 10-A, 46, 47, pub-
lished by the State Department of Education.
In the following pages of this publication the Florida Curriculum
Bulletins will be referred to only by bulletin number. Index to sub-
jects in these bulletins are listed on page 120.


-providing guidance throughout the child's
school life.
-relating the life of the school to home and
-developing functional curriculum.
-using flexibility in groupings and methods.
-arriving at democratic practices through
county-wide planning, total faculty planning,
and teacher-pupil planning.
-evaluating curricula and instruction in res-
pect to philosophy and goals.
The following statements summarize goals in the
Florida Program:
-development of well rounded and properly
adjusted members of society.
-improvement of individual and community
health, safety, and welfare.
-mastery of the tool subjects in a functional
-development of character, family life, and
-education for earning a living and for appre-
ciation of work.
-education for appreciation of aesthetic ex-
periences and use of leisure time.

The above goals and practices imply recognition of
the individual child's needs in every school and class-
room, and flexibility in carrying out the program to
meet individual differences. Increasing knowledge of
child growth and development, moreover, has led to
broadened understanding and appreciation of the indi-
vidual differences found today in any classroom. Differ-
ences are present at every age level not only in learning
ability for academic school subjects, but in physical
development, in motor functioning, in development of
the senses, in social growth, and in emotional maturity.
Teachers in Florida at both elementary and secondary


level are aware of guidance aspects in the teaching pro-
gram, and are making adjustments for group and indivi-
dual differences to an increasing degree each year. The
large majority of children may always be taken care of
in existing classrooms, but certain children because of
serious problems may require clinical study and special-
ized provisions with teachers trained in special educa-
tion. The classroom teacher does not have the special-
ized techniques and equipment required, for example,
to carry on lip reading instruction for the child with a
hearing loss, articulation and voice improvement for the
child with a cleft palate, or typewriting instruction with
a minimum use of eyes for the child with partial vision.
The classroom teacher cannot provide a sufficient num-
ber of varied first-hand experiences over a long enough
period of time for the child who learns very slowly.
Hence there is necessity for a plan of special education
for children with serious deviations.
The Florida plan provides for organization of Instruc-
tional Units at the county and local level according to
the child's particular needs. Units may be set up for
children who are slow-learning, children with hearing
losses, children with partial vision, children with crip-
pling conditions and other special health problems, and
for children who are home-bound or are in hospitals
and convalescent homes.
For children who can succeed in the classroom with
provision for corrective speech and lip reading instruc-
tion, Instructional Units may be set up and assigned to
itinerant teachers.
Common pupil needs in the special education program
are:. (1) discovery, study, and diagnosis; (2) medical
treatment; (3) adapted curriculum and specialized
methods; (4) specialized equipment; (5) individual
guidance; (6) vocational counseling; (7) vocational
training; and (8) placement. While these are common
needs they vary for the individual child according to the
kind and degree of his particular problems.


With the discovery of the problem and provision for
services at the elementary school level, some children
would be aided to full return to the elementary or
secondary program without further provision of special-
ized services. Others would have need for a special
program throughout their school life. It is well to call
attention here to the particular problems which arise in
adolescent years for the exceptional child. Guidance,
both educational and vocational, is a vital and necessary
part of the secondary school program. As time goes
on and there is more special education provision at the
elementary years, the pupil should be better prepared
for secondary school adjustment and guidance aspects
will take on greater significance.

Under the Florida plan the county board of education
is made responsible for locating exceptional children
within the school district and for establishing Instruc-
tional Units for them under the general direction of the
State Department of Education. Such provisions are
financed in the same manner as any instruction unit by
state allotments for teacher salary and in certain in-
stances for capital outlay.'
A county program calls for concerted plan and action
in setting up Instructional Units in order to insure their
acceptance and success in school and community. Cer-
tain desirable steps are outlined below to aid the county
in organizing a unit. As the reader peruses the succeed-
ing pages in the bulletin, he will note that these various
steps are discussed and sometimes reemphasized in
philosophy and recommended practices. The -order of
the steps undertaken may vary from community to com-
munity depending upon available personnel and re-
sources. No county, however, would want to omit any

IThe law recognizes the responsibility of the state for making trans-
portation units available for exceptional children; however, necessary
state funds on a county matching basis are not available in 1948 to
carry out this intent of the law.


of them. Assistance may be secured from the State
Department of Education at any step in the planning.
Steps to be Followed: The following are necessary
steps to be taken by a county setting up a unit.
(1) Arrange for study conferences with key school
personnel and with the State Department of Education
Consultant to develop a knowledge of trends, practices,
and goals in special education and to consider the pro-
gram in relation to the total program of instruction.
(2) Locate pupil candidates in cooperation with
related agencies and private physicians.
(3) Arrange conferences of county school personnel
as frequently as needed to consider needs of individual
pupils and program.
(4) Arrange conferences with representatives of local
health agencies and the child welfare committee of the
County Medical Association to advise on medical aspects
of the program.
(5) With the cooperation of the local Health Director,
who is by law in Florida a physician, utilize existing
resources to provide for the candidate an examination by
a pediatrician and further examination by other spe-
cialists as indicated.
(6) In addition to medical study and diagnosis,
provide psychological study of candidates.
(7) Make provision for the keeping and filing of
clinical records in addition to the cumulative guidance
record kept for all pupils.
(8) Select a qualified teacher certified to teach in the
area of exceptional children which the Instructional
Unit will serve.
(9) Following the initial steps in planning or evaluat-
ing an exceptional child program, apply to the State
Department of Education for approval of the proposed
unit prior to May 15.
(10) Carry out total faculty planning in the school
district of class location.


(11) Assign the classroom.
(12) Purchase equipment, supplies, and materials.
(13) Call conferences as needed of county representa-
tives from related public agencies to discuss the school
program and to coordinate planning.
(14) Arrange conferences with individual parents
concerning entry of pupils in special education class.
(15) Make necessary reports to county and state
Departments of Public Instruction.
(16) Review steps listed above to assure understand-
ing and completion of all necessary matters pertaining
to the establishment of a unit.
The State Plan of Education of Exceptional Children
is one of the more recent provisions in the total Florida
Program of Instruction and is in process of development.
Emphasis throughout this bulletin is placed on the inte-
gration of special education in the total program of the
school and on the utilization of related agency resources
for the individual child. As the program moves forward
there should be constant vigilance to assure flexibility of
means and methods and integration of services in the
whole structure and function of the school system.



Education for the exceptional child may succeed to
the degree that it is planned to meet needs in the local
community and is integrated in the total school program.
When the supervisor, principal, and teachers carry on
joint-planning from the beginning in discovering chil-
dren, in studying their problems and needs, and in
arranging services, then an achievement of goals should
follow. As the program develops the county supervisor
as coordinator should be ever ready to counsel and
assist in any way possible since there are many details
to follow through in launching, carrying out or maintain-
ing these additional services.

The principal is the administrator on whom the lead-
ership of his school, including the development of the
special education unit and its services rests. His philo-
sophy and his knowledge of the goals in the program
may determine to a large degree its acceptance, its inte-
gration in the total school program, and its success.
Through insight and planning, he should in cooperation
with the teachers and the supervisor lay the groundwork
in school and community for opening a new unit. He
should be zealous in providing favorable room location
and adequate equipment. He should make available the
same opportunities for the exceptional children as those
enjoyed by all children. For the established class, he
would frequently study its program with the supervisor,
the teacher and the entire faculty for the purpose of
promoting goals and integration of class and pupils in
the life of the school. The special education teacher
she'l.: be ever alert to many ways of providing for pupil
participation, such as: (a) scheduling classes or small
groups of children for special subject services such as
music, physical education, shop, and home economics;


(b) planning cooperatively for assembly programs and
school drives; (c) giving membership on traffic squad,
school council, library aides, and school teams; and (d)
exchanging invitations with other classes for classroom
activities. In certain units for children with physical
problems the child will benefit from attending specific
instruction in the grades.

The principal, teacher, and supervisor-would cooperate
in seeing that in as far as possible all essential services
-health, social, psychological, educational, and voca-
tional-are provided for the individual child. For
example, without necessary medical services for eye or
ear care the individual child may be unable to benefit
from the program. At high school level without referral
to the supervisor of rehabilitation, helpful planning for
vocational training is often overlooked. Conferences to
evaluate the pupils progress should be held as needed.
The principal would aid also in the articulation of the
program for groups and for individuals from elementary
school to junior high school and from that school to
senior high school. It is recommended that the element-
ary principal and special education teachers plan for
conferences with secondary school personnel to inter-
pret group and individual pupils' needs in order to
assure the continuance of optimal guidance and services.
Regular attendance is as important for the excep-
tional child as for other children. Any county for whom
a unit is authorized would be expected to provide no
exceptions in the compulsory attendance of exceptional
children of school age. "Home-school cooperation" is
discussed on page 107.
Fostered by principal and teacher as a vital part of
the program, home-school relationships should aid
greatly in maintaining satisfactory attendance.
The appointment of qualified county consultants or
supervisors in special education for individual counties


or adjoining counties is highly recommended. Such a
consultant trained in the field would give able assist-
ance to principal and teachers in the several phases of
the program.

The function and responsibility of the school for the
betterment of exceptional children may be realized to
an increasing degree as more citizens from both profes-
sional and lay groups are made aware of the state plan
and its implementation in the local community. Once
again, the school administrators in cooperation with the
special education teachers have opportunity for leader-
ship. It is essential that the entire teaching and admin-
istrative personnel, coordinating agencies, and the public
in general understand and accept these specialized
services that benefit not only the individual and his
family, but the entire school and community.
Preparation for understanding and accepting the pro-
gram should come first, through joint planning within
the school system referred to at the opening of this dis-
cussion; second, through coordinated agency planning
to be discussed later in the manuscript; and third,
through contacts with local community groups. Every
school district will find within its area one or more
organizations whose interest can be enlisted. Audiences
which welcome information from principals and special
education teachers are: (1) fraternal and service organ-
izations such as the Kiwanis, Lions, Rotary, American
Legion, Shrine, Elks, and private groups serving crip-
pled children; and (2) organizations such as, State
Congress of Parent-Teachers, Junior Women's Club,
Junior League, and General Federation of Women's
Clubs; (3) Chambers of Commerce; (4) leaders of
church and recreation groups; and (5) citizen councils
for health and social welfare.
In summary, the school is the source from which the
success of the program emanates. The faith and enthu-
siasm of the principal and the special education teacher,


the success which the boys and girls are having under
their guidance, and the warm bond of human relation-
ship which the teacher shares with the children and
their families,-these furnish the basis for better under-
standing and growing acceptance of the individual class
in the community and of the larger statewide program.

For Administrators:
Baker, Harry J., Introduction to Exceptional Children, MacMillan
Company, New York, 1947. 496 p. $3.50.
Heck, Arch 0., Education of Exceptional Children, McGraw-Hill
Book Company, Inc.. New York, 1940. 536 p. $4.25. (Note Chapter I).
Journal of Exceptional Children, International Council for Excep-
tional Children, Saranac, Michigan. Eight issues, $2.00.
Martens, Elise H., Needs of Exceptional Children, U. S. Office of
Education, Leaflet No. 74, Government Printing Office, Washington,
D. C., 1944. 20 p. 10c.




All the highly desirable qualities for any teacher
should be exemplified in the choice of a teacher for
exceptional children. Moreover, she should excel in cer-
tain qualities because of the unusual demands in her
position. The teacher must have faith and optimism
in the program. She must accept the child for what he
is and where he is, with a readiness to understand and
to meet his problem. She must have imagination, inven-
tiveness, a keen sense of humor, physical endurance, and
emotional stability since she must exercise patience,
accept irregularities with poise, and adjust readily to
varied situations. She must be a person who works
well with others and readily shares responsibilities. In
educational planning, whenever appropriate, she should
express freely her convictions and recommendations.
She should make a continuous study of the situation in
her area for anticipatory planning. She should be effi-
cient in keeping records and reporting progress on her
pupils and be prepared to furnish information required
by county and state supervisors.
A background of at least one or two years of teaching
experience with normal children is recommended.
Experience with children or youth in Sunday School
teaching, cub and scout troops, 4-H or camp work is also
The area of education for exceptional children is ever
growing in scope and the teacher has need, therefore,
to make professional contacts and to be alert to new
developments. She is encouraged to avail herself of
the stimulation and growth which comes from member-
ship and active participation in the local chapters of
the International Council of Exceptional Children, of
the Association for Childhood Education and in organ-
izations serving her particular area such as the Ameri-


can Association on Mental Deficiency, the National
Society for Prevention of Blindness, or the American
Speech and Hearing Association.
Finally, since part of her work includes public rela-
tions she should be prepared to inform members of her
community as to school plans and programs in the spe-
cial field.
The State Board has set up a plan of teacher certi-
fication for those engaged in the field of special educa-
tion'. A teacher must have completed prescribed
courses in the education of exceptional children, parti-
cularly in the sub areas of her specialization, and in addi-
tion must hold a graduate certificate.
Prospective teachers in the field should take as intro-
ductory a survey course in the education of exceptional
children. Courses in sociology, mental hygiene, and
guidance should be taken also, preferably before special-
Subjects usually required beyond those of an explora-
tory nature should include special methods, organization
and guidance applicable to the area, and clinical training
and practicum. Students taking work in any one area
or more are expected to take part in demonstration
classes during their academic training.
Supervisors, principals, and teachers are referred to
the teacher-education institutions in the state for further
information concerning teacher-training programs and
available courses. It is recommended that all adminis-
trators, supervisors, and teachers at both elementary
and secondary levels have at least one introductory
course in the study of exceptional children for two pur-
poses: first, to recognize symptoms in the child that
call for study and, second, to be fully informed so they
may give sympathetic consideration to the special educa-

'See Certificate Bulletin A, published by the State Department of


tion program and cooperate with those who are engaged
in it.
The successful in-service teacher must be given every
opportunity to satisfy certification requirements. To
this end the following recommendations are made: (1)
each teacher should submit a plan to satisfy permanent
certification requirements including a statement of the
courses to be pursued and the estimated time needed to
complete them; (2) scholarships such as Lewis and
others should be made available for these teachers: (3)
extension courses and workshops should be offered for
these teachers; and (4) as courses are completed the
teacher shall record that information with the state
certification section.

The problem of recruiting young men and women to
seek training in the field of education of exceptional
children becomes an important focal factor. To the end
that definite plans be undertaken in this direction, the
following suggestions are made: (1) teachers at second-
ary and college levels may be called upon to find prom-
ising young individuals whom they may personally inter-
est in training in this field; (2) from junior high school
through college, guidance programs should be made
available as a channel for presenting teaching oppor-
tunities in the area of special education; (3) concurrently
with building interest in the field, opportunity for
observing activities and for making contacts with excep-
tional children should be available to prospective stu-
dents with desirable characteristics and aptitudes; and
(4) lay groups should be urged to establish scholarships
for worthy young prospective teachers who may train
to teach such children in their own communities.
In the present teacher shortage some counties have
found it practical to draft one or more experienced
teachers who are interested in the program and have
them qualify through summer school work for positions
in special education.




According to the Florida Law, one of the premises
for giving specialized services is based upon clinical
study of each child and an analysis of his needs in rela-
tion to existing placement facilities. This fact suggests
that the initial and cumulative reports for the individual
child are a necessary part of the program. Further-
more, the organization of Instructional Units on which
state aid is based calls for reports and records of those
units. These reports and records include case studies
for individual pupils, information on pupil registration,
number of units, classification as to type of exceptional
child, enrollments, and attendance.

The titles of report and record forms are listed for
information and ready reference.
I. Forms A, B, and C for requesting state approval and
state aid are to be forwarded to the State Department
of Education by the County Superintendent prior to
May 15.
a. Instructional Units, Form A. Application for In-
structional Units. (To be made out in triplicate by
County Superintendent and forwarded prior to May
15. This is the form used by the County Superin-
tendent in applying for all Instructional Units
other than those based on Average Daily Attend-
b. Instructional Units, Form B. Information for
Approval of Individuals for Positions listed on
Instructional Units, Form A. (To be made out in
triplicate by County Superintendent and forwarded
prior to May 15. This is the form used by the
County Superintendent to report on all personnel
employed to fill units requested on Form A above.)


The exceptional child is found as the result of school health screening
procedures. Here a public health nurse and a health officer screen
two school-children as part of the school health program.
c. Instructional Units, Form C. Exceptional Chil-
dren. Operational Plan for an Instructional Unit
for Exceptional Children. (To be filled out in
duplicate by teacher and coordinator and forwarded
via the County Superintendent prior to May 15.)
II. Form At-15p. For furnishing information to the
State Department on the registration of exceptional
children, their location, their particular needs and
progress as to service for each child. (This form is avail-
able in the Principal's Record and Report Book.)
a. Form At-15p. Principal's Report on Exceptional
Children. (The principal should prepare in quad-
ruplicate and submit to the County Superinten-
dent who in turn secures the County Health Offi-
cer's signature by the end of the fourth month of
school. The County Superintendent should then
approve the report and forward one copy to thil
State Superintendent, return one copy to the
County Health Officer, and retain one copy.)
III. Form No. 1. For reporting the number of children
taught per month.
a. Exceptional Children, Form No. 1. "Monthly
Report of Teacher of Exceptional Children." (The


principal should have same made in duplicate
for the County Superintendent who in turn should
forward one copy to the State Department of Edu-
cation at the close of each school month.)


0 1

-Medical study is necessary for specialized planning for each excep-
tional child.

'i~t~c '~: --------


IV. Form No. 2. For reporting number of children per
a. Exceptional Children, Form No. 2 "Annual County
Report of Instructional Units and Enrollment."
(The principal should have made in duplicate for
the County Superintendent who in turn should for-
ward one copy to the State Department of Educa-
tion at the close of the school year.)

1. Instructional Units, Form A. Application for
Instructional Units.

2. Instructional
Approval of

Units. Form B. Information for
Individuals for Positions listed on
Units, Form A.

S. psychological study of the child is necessary too.


3. Instructional Units, Form C, Exceptional Children.
Operational Plan for an Instructional Unit for
Exceptional Children with date of approval of
State Board indicated.

-The school principal and the special education teacher study the
cumulative record of the exceptional child.
4. Form At-15p. Principal's Report on Exceptional
5. Exceptional Children, Form No. 1. Monthly Report
of Teacher of Exceptional Children.
6. Exceptional Children, Form No. 2. Annual County
Report of Instructional Units and Enrollment.

It is essential that a cumulative pupil record for each
exceptional child be on file in the office of the principal.
This record should include the original report with
recommendations for enrollment in a special education
class and the records should be supplemented at certain
intervals with reports of evaluation. Duplicates of spe-
cial reports of recommendation or other items should be
forwarded to the office of the County Supervisor.
The Florida Cumulative Guidance Record-grades
1-12 now in use in many schools is recommended for all
exceptional children. Filed with this record there will


be: (1) a case history of social and developmental back-
ground; (2) records of physical examinations including
vision and hearing tests administered by a physician;
(3) school history record; (4) the psychologist's report;
and (5) the special education teacher's annual report
of supplementary statements of the child's progress in
health, social adjustment, or other achievements. Any
summary statements for other items, such as speech
correction, lip reading, or physical therapy will also be
Original copies of special reports unless otherwise
stated should be kept in the office of the principal. The
records are confidential and should be available only
to professional workers who serve the pupil. Duplicate
copies of original reports when available should be for-
warded to the County Supervisor. As administrators
and teachers familiarize themselves with the plan of
records and reports, uniform reporting should expedite
and insure a better program of services to the individual
and the school community.






EU TIONFlorida TriCLDg A R ST T srO T I Tl G

FlorIdo rL E School for GeO CF



Florid TrDinTIg SFSchool for BoyA
FloRIdo TrToinig School lor Gi - DE- Y*I C
FloNUIdo F aorm Colony LA-N TEACHER CUSLR~





The development of a special education program for
the exceptional child is only one phase of a state wide
program in which education, health, and welfare services
share for the benefit of all children. In order to serve
the total needs of the exceptional child there must be
common understanding of his particular problems and
the closest cooperation at state, county, and local levels
on the part of public agencies responsible for the child's
welfare. To the degree that public agencies assume pri-
mary responsibility in their respective fields and inte-
grate their services, the child's major needs can be
served through: (1) case findings; (2) diagnosis; (3)
medical treatment; (4) education, vocational guidance,
and training; (5) job placement; and (6) auxiliary pro-
grams such as social services, physical therapy, and
other follow-up services. Agreement on utilization of in-
tegrated authoritative lines of responsibility results in
more effective service and eliminates duplication of
As the legally responsible educational agency, the State
Department of Education has accepted its obligation to
initiate and coordinate on overall state plan of necessary
services for public school exceptional children which
utilizes docal resources. Under this plan the State
Department's responsibilities include the promotion of
leadership at the county level in determining the scope
of services to be utilized in that community. To this
end the existing resources have been studied over the
state and there is an agreement on cooperative policies
between public agencies who have primary responsibili-
ties for services to children in the broad fields of public
health, medical care, welfare, and education including


Upon invitation to advise on the medical aspects of
the program, representatives of the State Medical Asso-
ciation have responded ably in giving counsel concern-
ing medical criteria for special education. They ex-
pressed a desire to support the program and assist in
the development of high standards. Similarly at county
and local levels the public school exceptional child pro-
gram looks to child welfare committees of the County
Medical Associations to assist in advisory capacity to
the program.
The Organization Chart of State Provisions for Excep-
tional Children on page 22 shows in a general way the
lines of responsibility and relationships. A coordinated
plan should be carried out at county and local levels,
whenever there is the recognition that certain children
have unusual problems which require specialized serv-
ices. The county school supervisor, designated by the
county superintendent and principal, should act as the
educational representatives to coordinate school, health,
and rehabilitation services at the local level and to keep
agencies informed of needs and of the special program
that the school has to offer. At least once a year or more
often, the county school supervisor, in cooperation with
the principal and special education teachers, should
arrange for round table conferences to which represen-
tatives from the county health unit, district welfare
board, and vocational rehabilitation services are invited.
Such meetings would afford an opportunity for the
members of related agencies to become intimately
acquainted with the programs of one another on behalf
of the exceptional child and to plan cooperatively for
any current needs. It would be advisable to hold such
conferences before the opening or extension of special
education units to enlist the interest, support, and assist-
ance of all workers concerned with the problems of the
individual child.
In addition to conferences, some plan for brief writ-
ten bulletins listing personnel and pertinent information
for the year may be helpful. At any time throughout


the year the supervisor acting as coordinator will wel-
come any suggestions from the county health unit, dis-
trict welfare board, or district rehabilitation service
worker that may further or strengthen the total pro-
gram. To the degree that there is mutual understanding
and sharing of knowledge and procedures, to that degree
the program may be expected to succeed and to grow.
It may be noted here that in many communities there
are councils of social agencies, health councils, child
welfare councils, or other local committees on which
there is a representative from the school system. Such
a representative should make himself familiar with the
needs of the exceptional child and available educational
services so that he may keep the council informed on
the subject and enlist their cooperation in the study and
promotion of the school program.

Florida's School Health Program' for sometime has
included a coordinated plan between the county office
of education and the county health unit on behalf of
better health for all children. As a result of school health
procedures, administrators and teachers may recognize
many symptoms of health and behavior which call for
further study. Children with physical problems have
varied health and medical needs which should be brought
to the attention of the county health unit by the school
supervisor and principal.
Exceptional children who are discovered by school
health screening procedures, by social worker, public
health nurse, local physician, or other source may be
cleared with the county health director who in turn
will refer them to private physicians, or state and
resource agencies for examination, diagnosis, recommen-
dations, treatment, or any other health service that may
be needed. In some communities private agencies and
service groups cooperate with the county health unit

ISee Bulletin No. 4.




Individual treatment and
corrective program

Oral surgery (in some

Transportation to centers
if needed

Child guidance service
when needed




(3-5 Yrs.)


of language
concepts and
ability to

Training in
lip reading
and sp~crch





Training in
speech and
lip reading

of residual




work (in
some cases)






Orthopedic care


Occupational therapy


Special furniture,
equipment and building

Home or hospital

Needs of Exceptional Children may be met individually or by


Medical attention

Individual health

Special equipment for
health needs

Home or hospital

Psychological study

Adapted curriculum

Special supplies and

Child guidance service

Environmental control

Psychological study

Enriched curriculum

Training for leadership

group services through a coordination of Public Agency Services.1

1. Material adapted from:
Martens, Elise H., "Needs of Exceptional Children", Washington, D. C., U. S.
Office of Education, 1944. p. 8.



and the school in securing correction in the medical
aspects of the program.
For assistance in other services such as maternal and
child health, mental hygiene service, preventable dis-
eases, and tuberculosis, the supervisor or principal may
consult the local health unit.1
The Florida Crippled Children's Commission is one
of the cooperating public resource agencies which
receives referrals of children with crippling conditions
from the county health unit and other sources. This
agency gives health and medical services for crippling
conditions to the dependent child or the child whose
family is financially eligible for such assistance. Types
of services furnished by the commission are: (1) dia-
gnostic and treatment clinics; (2) medical and surgical
care and special consultant services; (3) hospital and
convalescent care; (4) orthopedic field nursing service;
(5) physical therapy and X-ray; (6) braces, shoes, arti-
ficial limbs, etc.; and (7) transportation for patients to
clinics and hospitals.
The Florida Council for the Blind cooperates by pro-
viding medical, social, and rehabilitation services to
both children and adults who have a serious visual loss.

The district welfare offices are ready to cooperate not
only in rendering service to exceptional children and
their families but in promoting understanding of the
total program.
Social services available through the district welfare
offices vary a great deal from county to county. Since
there are no social workers on the school staff, it is
important that the principal and special education teacher
keep fully informed as to the assistance that can be given
in their particular district.
iThe State Board of Health is in the process of developing local
Mental Hygiene Clinics in larger centers where individuals may receive
study, diagnosis, and treatment.


Some of the social services available at county and
local level which may be needed by exceptional children
are: (1) financial assistance; (2) provision for the care
of children away from their own home; (3) casework
services for parents; (4) casework services for children
with personality difficulties or beginning behavior prob-
lems ; (5) assistance in referring children to institutions;
and (6) housekeeper service.
In addition to the above services the social worker
may sometimes be the person who is most able to inter-
pret the purpose of the school to the parent. The social
worker who knows the family should be invited to the
study conference on the child, at which information is
pooled and recommendations for education or other
needs are made. In some cases, her counsel will aid the
family in accepting enrollment of the child in a special
education class.

Of'particular significance to the exceptional child is
the provision for vocational rehabilitation. Seven dis-
trict offices over the state are available for consultation
concerning all matters pertaining to optimal vocational
preparation of youth with disabilities from sixteen years
of age and upwards. These services are intended as a
legal right for any individual. They are: (1) guidance
in the selection of a vocation; (2) training for a vocation
in school, on the job, or by other means; (3) surgery,
hospitalization, and treatment needed in order to remove
or diminish a disability which is a vocational handicap;
(4) artificial appliances necessary to enable persons to
work; (5) assistance in finding work which disabled
youths are capable of doing.
Florida schools have not as yet fully availed them-
selves of the opportunities that are offered for indivi-
dual pr,,,ia through rehabilitation. It should be empha-
sized tnat this agency does not give case-finding service.
The school, therefore, must take the responsibility for
informing the district office of all youths sixteen or


older, whose physical condition or limited intellectual
capacity may prevent them from securing a job without
further study, medical treatment, or training. These
agents are specialists who have counseling techniques,
knowledge of vocational training and job outlets, and
can match the prospective training to the capacities and
needs of the individual. The rehabilitation supervisor
should be frequently invited by the principal and teach-
ers to observe the pupils in school activities, and to
attend conferences at which the individual pur'l's capa-
cities and limitations in the vocational aspects of the
school program are discussed. Such contacts should net
rich return for both rehabilitation and school personnel
toward mutual understanding and more ready recogni-
tion of the opportunities afforded pupils by joint-plan-
The Florida Children's Commission was created by
the 1947 State Legislature. It is a state commission
with a program of study and action for the betterment
of child welfare, and is designed to educate and inform
the layman. Commission county committees have been
organized in 67 counties. Citizens with "deep concern
for children, with broad interests, specialized knowledge.
and abilities to plan effectively" were selected as mem-
bers. This commission has already published a plan of
study and is in a position to compile information and
advise with all agencies.

State Department of Education, Tallahassee
Education of Exceptional Children and Youth
Florida Vocational Rehabilitation Service
State Board of Health, Box 210, Jacksonville
Florida Crippled Children's Commission, Boom 328,
Caldwell Building, Tallahassee
'See Appendix Section 6 for location of your nearest district or county


State Welfare Board, Box 989, Jacksonville
Florida Council for the Blind, 918 Tampa Street,
Florida Children's Commission, Room 59-A, Caldwell
Bldg., Tallahassee

Florida Industrial School For Boys, Marianna
Florida Industrial School for Girls, Ocala
Florida School For The Deaf And The Blind, St.
Florida Farm Colony, Gainesville


The objectives of the program are directed toward raising the general
speech performance of the children whom it serves .to grow in
social. personal and occupational adequacy.-Photograplis courtesy
Miami Daily Nei'cs.




A child shall be considered in need of corrective speech
services if his speech prevents him from normal oral
communication, contributes unfavorably to his personal
adjustment, or is undesirably conspicuous. In some
instances, minor deviations which present no emotional
problems at the time observed, may have an undesirable
effect as the child grows older. On the other hand, one
must not be so sensitive to individual differences in
speech habits that unnecessary critical attention is
pointed at a child because of a simple deviation thereby
creating in him a speech problem when none of impor-
tance previously existed.
Great care must be exercised by classroom teachers
and others in referring certain children for special work.
In some instances the child is not aware of an irregular-
ity in his speech and unless the arrangement is taken
care of properly, adverse attention may be drawn to
the problem and result in accentuating what is only a
passing phase in his speech development or a minor

Factors which determine whether a child's speech
requires special attention may be stated as follows:
1. Speech should be appropriate to the age of the
child. If the child's general maturation is somewhat
delayed, the infantile speech need not be regarded as
an abnormal condition except that it is another evidence
of his general immaturity. Persistent baby talk, how-
ever, from an otherwise normally mature child in the
first or second grade, should be regarded as an irregular
condition which can be corrected easily and might
become significantly detrimental if allowed to continue.


2. Speech should be. appropriate to the mental or
cultural capacity of the child. Speech might be regarded
as defective when regional substandardisms, articula-
tory mannerisms, vocal qualities, and similar problems
are not on a level with the culture of the child's environ-
ment and his intellectual interests. On the other hand,
when speech habits already have reached the level of
mental capacity, it is doubtful that further pressure
should be exerted to achieve higher communication
skills. Such instruction might create an inhibiting force
in the child, and at some levels even emotional frus-
3. Speech should be intelligble. There are many arti-
culatory problems in children such as reversals of sounds,
imperfect production, or omission of consonants and
sound substitutions which alter words so that they are
sometimes difficult to recognize and so become confus-
ing to the listener. Such defective sounds sometimes
occur simply and are easily isolated and corrected,
while, at other times, they occur in many combinations
and completely distort the speech. While some of these
cases are often purely imitative or perseverative in
nature, this category often includes the child with cleft-
palate, cerebral palsy, or hearing loss.
4. Speech should be audible and pleasant to hear.
In some children, the voice lacks force, or is monotonous,
or too high or too low in pitch, rendering it inexpressive
and inadequate. Others have unpleasant qualities such
as nasality, coarseness, or aspirations stemming from poor
use of resonators or improper vocal control. Again, these
irregularities may result from organic factors or simply
be the result of environmental influences.
5. Speech should be fluent. The problem of stutter-
ing is one which demands most careful and understand-
ing concern. While it is important to recognize the
presence of non-fluency and to select such cases for
special guidance and instruction, considerable wisdom
should be exercised to insure the child against the


aggravation of his problem while trying to help him.
It should be recognized that periods of non-fluency are
normal and to be expected during the beginning years
and under certain circumstances, and that undue atten-
tion at these times may cause a disorder to result.
While these criteria may not cover the entire field of
speech irregularities, they should serve as a guide in the
selection of pupils for special help. In the last analysis,
in discriminating between adequate and inadequate
speech, one should always keep in mind environmental
circumstances which encompass the individual, his poten-
tialities, and his mental, physical, and emotional matur-
ity. Early recognition of children who need special
training to overcome speech difficulties cannot be over-
emphasized. The public schools cannot immunize against
speech defects, but can promote a preventive program
and retrain at a time when speech habits are being
formed, and before wrong patterns have become habitual.
The Florida State Law has made provision for setting
up Instructional Units for public school pupils who will
be benefited by speech correction services. Such Instruc-
tional Units will be taught by full time itinerant teach-
ers trained in speech correction to whom these pupils
will be assigned for regular weekly periods.
This provision will net rich return to the individual
child, the school, and community because the large major-
ity of these children following a period of instruction
will return to fuller participation in classroom activities
and will enjoy the benefits of acceptable speech. Only
the most extreme problems will need continued service
over a period of years.

The study of children to determine speech needs should
be made on a comprehensive and factual basis in order
that only children in actual need of the service may be
enrolled. The initial point at which the individual's
problem is recognized may stem from several sources:


Surveys: In counties inaugurating a program, the
speech correction teacher should make a careful survey
of the schools to ascertain the number and types of prob-
lems in her area of responsibility. Ideally, the teacher
trained in speech correction would interview each child in
the primary, elementary, and secondary programs. When
this, however, is not practical nor possible in a county
because of its large school population, a combination
method might be used. She may screen the kindergarten
and/or the beginning primary level, going as far through
the elementary levels as possible. She may then make
only a study of selected pupils referred by the classroom
teachers of the elementary and secondary groups. If
the classroom teachers assist by selecting children for a
diagnostic testing it is suggested that they participate
in group conference sessions. In such sessions, the
speech correction teacher describes and classifies the
types of speech problems common to childhood.
As the speech correction teacher proceeds in the sur-
vey she should utilize any information on the individual
child that is available as a result of school health pro-
cedures' and any reports from related agencies. In addi-
tion to her findings, such information, including audi-
ometric tests, will serve as her means for discovering the
individual in need of diagnosis.
Once a program has been initiated, the speech correc-
tion teacher will screen each year all first year pupils
and any new pupils entering on the elementary or sec-
ondary level. No single survey pattern may be outlined
as suitable to all counties but a plan suited to the specific
school system which promotes the program should be
developed through joint-planning with the county super-
Referrals: Teachers and administrators should be on
a constant lookout for children needing special help, and
make referral to the speech correction teacher.
Parents should be encouraged to report to the school
personnel any particular speech problems that they feel
1See Bulletin No. 4.


need attention. The family physician, county health
unit, welfare a~;o :1i..-, and others are often the source
of individual referrals.
Study of the Child: The speech correction teacher
systematically begins her diagnostic procedures with the
pupils selected for study. The data thus obtained, along
with the routine medical examination of the child which
is a part of the school health program, may give suffi-
cient evidence of need for special education.
When the Health Director and the teacher feel that
further diagnostic study is necessary, the following
information needs to be brought together: (1) a case his-
tory of social background and developmental speech
secured in parent-teacher conference; (2) the results of
a complete examination by a pediatrician (including that
of specialists, such as an otholaryngologist, and otologist,
if indicated by the physician); and (3) a summary of
school progress.
The child is then studied by one qualified to adminis-
ter psychological tests, performance and social maturity
scales, and personality tests. The findings of the psycho-
logist, the speech correction teacher, and consulting
physician, are discussed in conference with principal and
classroom teacher in attendance. In some instances it
is helpful to invite parents to be present. Recommenda-
tions for medical treatment, and/or social and educa-
tional adjustment may grow out of this conference
period. On the special education teacher rests the respon-
sibility for corrective techniques and coordination of
total services for the child.

The State Regulations provide that wherever there
are exceptional children who will benefit by specialized
corrective speech training, an Instructional Unit may
be set up by the county and taught by a speech correc-
tion teacher on an itinerant basis.


If past experience and normal expectancy may serve
as an indication of need, there is no county in Florida
where there is not a sufficient number of children needing
speech correction supplementary to their regular school
program to justify the employment of a trained teacher.
The number of pupils will vary for different communi-
ties and will depend upon the social and economic status
of the population. In general, approximately ten per
cent of all children of school age will have speech irregu-
larities. This percentage is high when only the severe
speech problems are considered and may be low when
slight articulatory and vocal irregularities are included.

. an extension of the regular classroom work.-Photograph courtesy
Miami Daily News.

It must be made clear at the outset that the provision
of an Instructional Unit for speech correction services
taught by an itinerant teacher implies close coordination
with the classroom program. Pupils assigned to this
type of Instructional Unit remain in the classroom and
are assigned to regular weekly periods with the special
education teacher. Further, it must be pointed out that
the program must be regarded as an extension and sup-


plement of the classroom instructional program rather
than as a super-imposed or separate structure.

A corrective speech program can be very flexible and
can lend itself readily to existing school facilities and
organization. The teacher assigned in an itinerant role
to serve several schools may operate in one of a number
of ways. She may assist classroom teachers in part-
time correction work in their individual schools by teach-
ing them special methods, supplying them with practice
and test materials, teaching demonstration lessons, and
testing. Of primary importance is the organization of
a schedule which permits: (1) individual instruction of
the child; (2) coordination of speech instruction with the
classroom teacher's program; and (3) a cooperative
plan which permits joint study of the child and his
environmental relations in the school community.
Room and Equipment Needs: The only additional
physical facilities necessary to initiating a county pro-
gram is an adequate working space in each school build-
ing to which the teacher is assigned.
The teacher should have a private office (preferably
acoustically treated) in a centrally located school. This
space will serve as a headquarters for files, special
equipment, such as speech recorder, and supplies, and
as a suitable place for interviews and diagnosis. In each
of the schools, where she is scheduled, she should be
provided with a large quiet room near the groups which
she serves. Although elaborate equipment is not neces-
sary, every effort should be made to provide at least
the minimum essentials.1
Teacher's Work-load: A speech correction teacher
should not be expected to handle more pupils in a given
area than she can serve adequately.
The teaching load will vary in the light of the type
and severity of the speech irregularities, the number of
IMimeographed material on the subject of "Rooms, Equipment and
Supplies" is available from the State Department of Education.


schools served, and the time which the grade teacher can
give. The operational plan will show a definite schedul-
ing of the time of the teacher and pupils. Some of the
pupils have to be taught individually. Others with
similar problems may be taught in a group when ages
are compatible.
The efficiency of the program is measured in final
results and not in terms of the number of children con-
tacted. An itinerant teacher may adequately serve a
minimum of 50 pupils in a county. It is probably unwise
for one teacher to serve more than 75 pupils each week if
the individuals are seen for two half-hour periods per
week. On the basis of scattered area, mildness of prob-
lem and the degree of cooperation of grade teachers, a
greater number of students might be scheduled.
The Over-all Plan: After there has been an inventory
and survey of the county, it can be determined where
the greatest number of cases are concentrated. An over-
all plan covering two or three years is recommended in
which the teacher will begin her work in the section
where there is the greatest need. This may mean that
some outlying school with few pupils might not be
served the first year unless they can be transported or
transferred to a school receiving service.
With the number of cases existing in the larger school
system one should guard against the giving of preference
to the city schools over the unconsolidated rural schools.
It may be possible to develop a balanced plan of local-
izing instruction by serving large numbers of pupils in
the city schools for 2 or 3 days a week and by devoting
the rest of the week to outlying communities.
When a general speech teacher is employed in the high
school, the speech correction teacher may become simply
a consultant in that school. On the other hand, the two
teachers may work out a cooperative plan of operation.
In some instances, when speech irregularities are slight,
it will be possible to discontinue the work in speech
correction while the child is still on the lower grade


levels. In the case of such severe problems as cleft-
palate, cerebral palsy, and hearing loss, however, it will
be necessary to continue the service into the secondary
Until the program of special education for the pupil
with speech irregularity has been in operation over a
period of time, there will be high school pupils who have
not had the benefit of speech correction. Any pupils
sixteen years or over who have irregularities that may
limit their vocational placement should be referred to
the Vocational Rehabilitation Service for special assist-
ance. If a speech problem is a vocational handicap, this
agency can offer for example, surgery, hospitalization,
and treatment for organic disabilities associated with
speech problems. It also furnishes appliances such as
prostheses for the youth with a cleft-palate.

Pupils with slight to moderate hearing loss sometimes
have speech irregularities. Lip reading and speech in-
struction may be provided for these children as a part
of the corrective speech program.
In the larger counties where proportionately more chil-
dren with hearing loss are found, careful study should
be made of both speech and hearing needs to determine
the best plan for teaching services. Provisions for chil-
dren who have a moderate hearing loss or moderately
severe loss are discussed in the section "Children with
Hearing Losses."

To facilitate the study and treatment of speech irregu-
larities State Department forms namely, the Medical
Examination Report (For speech problems) and the
Speech Diagnosis and Record Folder have had trial
use in the state and are recommended as covering cer-
tain essential items.'
iFor samples of these forms see Appendix Section 5d and 5e.


If the child is examined by a physician, his findings
should be recorded on the Medical Examination Report
or other form. The Speech Diagnosis and Record
Folder or other suitable form will be filled in by the
speech correction teacher as she completes her testing
program and receives information from other workers
and parents. Such forms properly made out become a
profile of the speech problem, a. summary of causative
factors, a record of the instructional program of progress,
and of final accomplishments.
The above records are kept on file by the speech cor-
rection teacher as long as the child is enrolled with her.
Upon dismissal they become a part of the Cumulative
Guidance Record, Grades 1-12.
The instructional program for the child with speech
irregularities is the same as for children of his class.
It is well to emphasize again that the plan for speech
correction is not a program within itself, but an exten-
sion of the classroom work through supplementary
instruction by itinerant teachers for those children who
need such instruction to correct speech problems. It
should be set up in such a way as to meet the overall
goals in education and be a part of the school curriculum
which it enriches.
Program Objectives: The objectives of the program
are directed toward raising the general speech perform-
ance of the children whom it serves. A curriculum full
of suitable oral experiences will allow the individual to:
(1) develop understanding and voluntary control of the
speech mechanism; (2) become more aware of his speech
environment; (3) grow in social, personal, and occupa-
tional adequacy; and (4) develop confidence, self-depend-
ence, and freedom through oral communication. The
teacher will find it helpful to consider the child's devel-
opment from primary years to the period of adolescence
when there is the personal urge for social and occupa-
tional adequacy. With this long-range view of individ-


ual growth potentialities, she will focus on the goals
stated above and on their significance for each child as
he grows toward increasing maturity.
How to Develop the Program: There are several
ways in which the instructional aspects of the program
can be developed and carried on. Any one approach
may be better suited than another to the existing cir-
cumstances in a given county and to the personality and
capacity of the teacher. On the other hand, varied
approaches might be employed in certain counties or by
certain teachers. Factors which determine instructional
procedures include: the school program, the special
teacher's training and personality, the administration's
attitude, the classroom teacher's training, the number
and severity of the pupil problems, and the number of
other units for exceptional children.
Special Techniques: The itinerant teacher of the child
with irregularities of speech should use methods of in-
L_._.- *

-The classroom teacher can help.


struction which follow the plan and procedures recogniz-
ed and taught in the higher education training programs
for teachers of exceptional children. Such methods
include specific techniques in phonetic ear training,
speech exercises, vocal analysis, psychological study of
the individual's responses, and use of personality inven-
tories. Irregularities in speech are often associated with
reading problems. The teacher working with speech
problems should coordinate instruction of the individual
child with his remedial reading program.
The actual content of the extended curriculum for
those children who seek adequacy in the spoken word is
found, not in books, but in many experiences which call
for complete visual, auditory, kinaesthetic, motor, and
mental responses on the part of the pupil.
The Classroom Teacher Can Help: There are nu-
merous ways in which the corrective speech teacher can
supply the classroom teacher with information regard-
ing special instruction which can be carried over into
daily classroom practice. Some examples follow: (1)
supplying her with a phonetic analysis of the child's
speech, designating sounds that are receiving attention
at the time; (2) preparing for her frequent reports on
the child's speech successes which should be reenacted
in classroom recitations; (3) designating the methods
used to obtain correction of errors which the classroom
teacher might utilize; (4) ascertaining from the class-
room teacher the reading materials, spelling lists, or core
curriculum projects and assisting the child with the arti-
culation and expression of that material; and (5) sug-
gesting a classroom activity in which the child might
successfully participate and at the same time use, for
example, certain speech exercises.
Mental Hygiene Practices: Mental hygiene goals and
practices are important aspects of the child's training
which must be entered into jointly by parents and all
teachers concerned. The child needs to feel security,
acceptance and success in his group, in speech class, in
the general school setting, and in the home. In no area


are wholesome family relationships and parent attitudes
more vital to the child's success. The speech teacher
has a special responsibility for working with parent and
home. See Chapter VII, Page 107, in which Home-School
cooperation is discussed.
There is need to create within the child the proper
attitude toward his limitations and his capabilities. Too
often a child tends to blame all of his failures upon his
speech limitations when, in fact, he lacks understanding
of the real causes underlying his behavior. Through
helping the child to recognize his personality problems
and their relation to his speech, the teacher can often
aid the child in accelerating improvement in his speech.
Back of the whole program is the need for dealing with
the "whole child"-his educational, social, mental, emo-
tional, and health needs.

Teachers employed for speech correction are morally
bound to a professional code of ethics. This code was
approved by the Florida Speech Association and is pat-
terned after the one designed and in use by the American
Speech and Hearing Association. It is an additional
clarification of the standards and procedures which
speech correction teachers should use while in the
employ of the state and county and should serve as a
guide in developing programs.
It should be recognized that a speech correctionist is
first and foremost a public school teacher and should be
governed by any principles or practices applicable to the
teaching profession. However, those speech correc-
tionists employed under Florida School Laws should, in
addition, be guided by the following Code of Ethics:
1. Professional Standards:
a. He shall strive to contribute to the growth and
development of the field of speech correction in the
county and state through the practice of high personal
standards of excellence in the pursuit of speech correc-


tion work, and shall seek to inculcate in the public gen-
erally an impression of his dependability, culture, knowl-
edge of techniques, and breadth of vision.
b. It is recommended that in order for such persons
to keep abreast of current developments in the field and
to insure his continued compliance with standards of
professional achievements that he maintain an affiliation
with the American Speech and Hearing Association at
the highest membership level he is qualified to hold.
c. He should maintain strict adherence to the poli-
cies determined by the State Board of Education in its
administration of any and all special education legislation
apertaining to teachers in the speech correction field.
2. Professional Attitude:
a. It shall be the obligation of the speech correction
teacher to maintain in strict confidence all personal
information regarding all individuals with whom he is
b. On the other hand, a teacher should regard it his
obligation to share with other workers information and
teaching aids that would be of value.
c. The speech correction teacher should consider it
his responsibility to maintain cooperative planning with
any other teachers interested in the same individual.
d. The speech correction teacher should maintain
such public relations with other groups, agencies, and
professions as would extend and increase the effective-
ness of the program.
3. Unethical Practices: It shall be considered unethi-
cal to:
a. Guarantee to cure any disorder of speech.
b. Take private fees for special speech correction
instruction. The only exception might be in the case
of an individual above or below the required public
school age when there is no provision for this special
instruction by an existing state facility.
c. Make "extravagant promises," difficult of ful-
fillment, in order to secure pupils or patients.


d. Employ blatant or untruthful methods of pub-
licity, or advertising.
e. Advertise to correct disorders of speech entirely
by correspondence.
f. Seek advancement by attacking the procedures of
other workers in such a way as to injure their standards
and reputations.
g. Pursue instructional procedures without advice
and authority of a physician when there is any question
of the need for medical examination.
h. Extend the time of treatment beyond the time
when one should recognize his inability to effect further

For Administrators:
Johnson, Wendell, and Others. Speech Handicapped School Children,
Harper and Brothers, New York, 1948. 464 p. $3.00.
For Teachers:
Backus, Ollie L., Speech in Education, Longmans, Green and Com-
pany, New York, 1943. 358 p. $2.75.
Eisenson, Jon, The Psychology of Speech. F. S. Crofts and Company,
New York, 1938. 280 p. $2.25. (Chapter VIII).
Johnson, Wendell, and Others. Speech Handicapped School Children,
Harper and Brothers, New York, 1948. 464 p. $3.00.
Journal of Speech and Hearing Disorders, The American Speech and
Hearing Association, c/o Speech Clinic, Wayne University, Detroit,
Michigan. Four issues, $3.50.
Nemoy, Elizabeth M. and Davis, Serena F. The Correction of Defec-
tive Consonant Sounds, Expression Company, Boston, 1937. $4.00.
Van Dusen, C. Raymond, Training the Voice for Speech, McGraw-
Hill Book Company, Inc., New York, 1943. 232 p. $2.50.
Van Riper, Charles, Speech Correction: Principles and Methods,
Prentice-Hall. Inc., New York, revised, 1947. 470 p. $5.35.
Werner, Lorna, Speech in the Elementary School, Row Peterson and
Company, Evanston, Ill., 1947. $2.00.
West, R., Kennedy, L., and Carr, A. The Rehabilitation of Speech,
Harper and Brothers, New York, revised, 1947. 650 p. $5.00.
For Parents:
Johnson, Wendell, "Letter to the Parent of a Child Who Stutters."
(Free reprint available from Exceptional Child section, State Depart-
ment of Education, Tallahassee, Fla.)
Johnson, Wendell, People in Quandaries, Harper and Brothers, New
York, 1946. 700 p. $3.75. (Chapter XVII).
Johnson, Wendell, and Others. Speech Handicapped School Children,
Harper and Brothers, New York, 1948. 464 p. $3.00.


a. adjust methods to serve the child with a hearing loss.




Children with certain degrees of hearing loss too often
meet frustration and failure in the classroom where hear-
ing and vision play so great a part in successful academic
achievement. Some of these children need preferred
seating and lip reading as an aid to better understand-
ing of the spoken word. Others will need lip reading,
the use of a hearing aid, and in addition auricular speech
and voice work. There are very young children at home
without hearing and speech who can benefit by expert
guidance and instruction long before six years of age.
For educational purposes and practical purposes of
communication, there are two main groupings of chil-
dren with hearing loss. There are the hard of hearing
and deaf. The deaf are those who do not have functional
hearing. The hard of hearing are those who can hear to
some extent but who have a hearing loss of greater or
lesser degree.
To meet varied needs, the state law provides for the
establishment of three types of Instructional Units for
children with hearing loss: (1) a full-time unit of pupils
assigned to a full-time special education teacher; (2) a
unit taught by an itinerant teacher and made up of
pupils who need lip reading instruction and sometimes
speech; and (3) a. unit for children under six years of
age who are deaf or have a severe degree of loss with
little or no speech. Description of these types of units
will follow later.
Estimates over the nation as to the number of chil-
dren in any given school population who require this
program differ due to lack of comparable standards for
selection and differences in health, social, and educa-
tional opportunities. A conservative estimate would
place the number at approximately 1.5% of the school
IMartens, Elise H., "Needs of Exceptional Children", Washington,
D. C., U. S. Office of Education, 1944. p. 4.


Causes from which loss of hearing may be an after-
math include: meningitis, scarlet fever, measles, whoop-
ing cough, mumps, influenza, and pneumonia. Frequent
and long-continued colds, diseased tonsils, and adenoid
tissue are conditions which, if allowed to remain, may
result in the spreading of infection to the middle ear.
Much preventive work can be carried out by discovery
of these last named conditions, with medical treatment
to follow. In a certain percentage of cases hearing
loss is due to hereditary factors. Among these condi-
tions is otosclerosis which is progressive in nature, and
its first stages may be manifested in adolescence.
Any child who shows more than a borderline hearing
loss, as discovered by a screening process, is referred
for a diagnostic test on a pure tone audiometer admini-
istered by a trained person. The otologist then in his
diagnosis determines the nature of the problem and
corrective measures indicated. The diagnosis of the
child's loss of hearing to be of the nerve or conduction
type or a combination of both, has certain significance
for the special education teacher. Further study is then
made of the pupil whose audiogram shows moderate
loss' or moderately severe loss2. It is helpful to make
available: (1) a case history of social and developmental
background; (2) an examination by a pediatrician,
including vision tests; and (3) the cumulative school
The State Board of Education in cooperation with the
State Board of Health has inaugurated a program of
School Health Services which provides, at certain inter-
vals, for physical examinations and screening procedures
to detect those children who do not have normal vision
and normal hearing acuity3.

IModerate loss (approximately 25 to 35 decibels in the better ear in the
speech range).
2Moderately severe loss (approximately 35 to 50 decibels in the better
ear in the speech range);
3See Bulletin No. 4.


The instrument most commonly used over a number
of years for screening hearing is the group audiometer.
As many as forty children can be tested at one time
with this instrument. The pure tone audiometer is
designed for individual diagnostic testing. It is used
with individuals who have been screened for further
study and testing. This instrument may also be used
as a screening device with certain procedures that per-
mit a hearing acuity check-up on a group of children in
a comparatively short time.
Children will be discovered not only in screening sur-
veys but at other times through physicians, nurses, par-
ents, welfare workers and others, and through daily
teacher observation in the classroom.
There are certain characteristics that are observable
by the alert teacher. These characteristics are: (1) inat-
tention and lack of interest in general conversation;
(2) failure to respond when called upon or called to;
(3) misunderstanding of oral directions and habitual
turning of the head to place one ear toward speaker;
(4) frequent requests for repetition of oral directions;
(5) tendency to play alone or with only one other child;
(6) peculiar voice quality; (7) failure in activities
dependent on oral instruction; (8) incomplete language
and inarticulate utterance; (9) undue restlessness fol-
lowed by being unduly tired by the end of the day; (10)
frequent colds; (11) discharge from ear; and (12) com-
plaints of noises in ear or ear aches. Children showing
these characteristics should be referred for study.
With this data at hand, principal, special education
teacher, doctor, nurse, and any other workers should
meet for conference to make recommendations for fur-
ther medical treatment, if necessary, and to plan for the
child's educational program. In some instances the child
may, for example, be so retarded educationally, shy, and
withdrawn that a study by a psychologist is advised
before the conference is called. The value of considering
all other factors, as well as hearing, in the child's devel-


opment and school progress cannot be over emphasized.
Decisions and recommendations should at no time be
made on the basis of the audiometer and otologist's find-
ings without consideration of other factors.

The state law empowers the county to organize full-
time Instructional Units for exceptional children on the
basis of ten or more pupils, who need the service. How-
ever, when evidencecan be submitted to show that there
are less than ten children whose hearing loss is so great
that the services of a full-time special education teacher
is required, provisions may be made for a unit with enroll-
ment of less than Iten. At no time should class size
exceed ten pupils for primary age children. At ages
above ten, classes may range from 10 to 12 pupils, all fac-
tors considered.
Unit I: Children with a moderately severe hearing
loss, who are recommended for a full day special educa-
tion program should be assigned to a unit taught by a
trained teacher. Thby should have intensive daily work
in specialized techniques such as lip reading, auricular
speech, and voice training. They should receive major
help in the basic subjects in the special education class-
room. They should also go to other classroom groups
of similar age and achievement level to participate in
certain work such as numbers or science.
Unit II: Children with a moderate loss who are rec-
ommended for a preferred seat, lip reading, and in some
cases speech work would continue to take the regular
curriculum in the classroom and may be assigned for
at least two weekly periods to an itinerant special edu-
cation teacher. The child who has a hearing loss less
than the amount stated, but due to a condition which
is progressive in character, should be included in this
group. This special training will supplement his hear-
ing and tend to relieve tension. This provision may be
preventive or corr active depending on the individual
child's needs.


Other Provisions: At the present time facilities are
available for totally deaf children, between the ages of
six and twenty-one, at the Florida School for the Deaf
and the Blind, St. Augustine. The state law also makes
provision for day-school classes for the young deaf child,
between the ages of three and six, in communities where
ten children are in need of this special service and a
trained teacher is available. This is considered highly
desirable in order that the child may have the advantage
of social and educational experiences and yet remain, at
this early age, in his home environnient. By joint
arrangement with the authorities in the Florida School
for the Deaf and the Blind a child may continue his edu-
cation in the day school after he has passed his sixth
birthday, provided the parents so desire and sufficient
personnel and facilities are available in the local unit
to meet adequately the situation.'

Following recommendations for placement in Units I
or II described above, the principal, teacher, or other
worker, depending on the individual situation, meets the
parent in conference to discuss the child's abilities and
problems and to make arrangements for transfer to the
In no area of the education for exceptional children
is there more need for individual study, guidance, and
instruction by a fully qualified teacher. In no area are
individual needs so great and varied in respect to every
phase of the child's functioning. Careful teacher records
on the progress in instructional content should be sup-
plemented by records of progress in the specialized
techniques and in social adjustment. Records of hearing
tests, medical check-up, and medical treatment are also
necessary. Evaluation in respect to progress and readi-
ness for increased participation in the school program
or full return to a classroom group should be made at
appropriate intervals for every child. The use of indivi-
ISee Bulletin No. 53.


dual hearing aids satisfactorily fitted and kept in
optimal service may make it possible for certain chil-
dren to take the major part of their work in the class-
room group.

The special education classrooms should conform to
standards set for a ly adequate and modern classroom.1
In addition special attention should be given to lighting.
The strain on the eyes of these children, who depend to
such a great extent upon visual cues, is greater than for
other children. Therefore, to facilitate ease in lip reading,
care should be taken that the room does not have cross
lighting, and the intensity should be at least 30 ft. candle
power. There should be little contrast in walls and
The classroom should be supplied with the standard
aids to instruction! for all classrooms. Extensive use
should be made of visual aids. Standard equipment for
this classroom should include a film strip projector
suitable for various types of materials, a grand piano if
possible which supplies an unobstructive view between
teacher and pupils in group rhythm and speech work, a
phonograph with a well-chosen repertoire of records,
and a speech recorder.2 A group hearing aid that can
be readily serviced] is necessary for group use.
Hearing Aids: Some children will not have individual
aids. The classrooms group aid enables the teacher to
control certain instructional situations and makes for
flexibility in planning work. The individual hearing aid
is advisable for the child who can benefit by its use. Of
recent years aids have been improved in design and func-
tion and children can more readily learn to adjust to
them. An aid should not be purchased without advice
from an otologist and without a plan for servicing it.
Primary responsibility for battery upkeep and optimal

ISee Florida School Bulletin, August, 1948.
2Mimeographed material on the subject of "Supplies and Equipment"
is available from the State Department of Education.


function should be taken by the parent. Since children
require much guidance in the matter, teacher and parents
should cooperate in follow-up. Children need instruction
for learning to wear an aid, and they also need acoustic

The curriculum for children with a hearing loss is
fundamentally the same as for other children. The dif-
ference is chiefly a matter of emphasis and of special
techniques used. Educational opportunities should be
provided which will allow each child to develop to the
maximum of his capacities at the rate of speed of which
he is capable. At secondary school age the child should
be assisted in acquiring the necessary skills in a vocation
suitable to his ability, aptitude, and interest. Self confi-
dence should be developed to such a degree that in time
he will be able to take his place as a contributing mem-
ber of his community.
Lip reading is one of the major tools by which lan-
guage is acquired. It is a special ability and research
has not shown that a close relationship exists between
this ability and intelligence. Success in this area, as in
all areas, will differ with the individual. The method by
which lip reading is taught will depend upon age of the
child at the onset of hearing loss. The child who has not
heard speech will build up from the beginning an associa-
tion with speech patterns on the lips through his eyes;
while, the child who experiences a serious loss of hearing
at five years or later after speech is well developed,
or, the child with moderate loss, will have spoken speech
patterns as a basis for acquiring lip reading techniques.
For many, the use of a hearing aid will be a new experi-
ence to which the child must be helped to adjust. Train-
ing will be required for some children in order that they
may learn to interpret new sound patterns in terms of
meaningful speech and language. For others there will
be need only for training to integrate hearing with lip


Language is the major concern of the teacher work-
ing with the child who has a hearing loss. Children who
can, with or without the use of a hearing aid, carry on
communication in a normal way should be provided
with many and varied opportunities for oral expression,
in addition to the oralism required to meet every day
situations. Language is a means of communication.
Motivation is much easier when this concept is accepted.
Language is not a special subject but the medium through
which subject content is learned. Hence the need and
value for the child to attend other than the special edu-
cation classroom and to associate with normal-hearing
children who are not restricted in the use of language.
Reading should be emphasized. Skill in meaningful
thought reading for acquiring information is not only
necessary, but it affords a pleasurable means for worth-
while use of leisure time. Irrespective of the degree of
hearing loss, each child should be held responsible at all
times for the best speech of which he is capable.

encourage him to take part in all group activities.
Art, dramatization, rhythm work, and crafts should
be carried on in the classroom situation and as extra
curricular activities. An interest in these activities might
well be the basis for hobbies.


Cooperation of the Classroom Teacher: It is especially
important that the classroom teacher have insight regard-
ing individual problems and that she is in complete
harmony with the program of special education. She
should have a functional knowledge of the problems
involved in acquiring skill in lip reading, adjusting to
hearing aids, and speech problems related to hearing loss.
Whenever possible, without upsetting the routine of the
class, she should adjust her methods to serve effectively
the child with a hearing loss.
The child should be given neither special privileges
nor neglected. He should, for the most part, share
equally with the other members of the classroom with
respect to demands made upon the teacher's time. For
him, participation in group activities should not only
be encouraged but carried out. The child who does not
wear a hearing aid should always have the privilege of
moving freely about the classroom in order to be near
the source of sound.
Suggestions for the classroom teacher are: (1) speak
distinctly, but do not "mouth"; (2) stand where the
child can see the movements of mouth, that is, at not too
great a distance, and where the light will shine directly
upon the face; (3) be sure that the child feels free to
move about the room in order to be near the speaker;
(4) be sure the child understands directions given orally;
(5) watch his health, but do not be over solicitious;
(6) be sure that the child understands his problems;
(7) encourage him to take part in all group activities;
and (8) encourage him to accept his disability and do
his best.
Parent Cooperation: In many cases, parents do not
understand the child who has a hearing loss. Thus, he
tends either to be over-indulged or neglected. A class-
room teacher-parent relationship should exist in order
that a better understanding may be developed which will
work for the good of the child. Families can help by hav-
ing the child participate in family activities and in organ-
ized social groups, such as scouts, playground clubs,


Sunday school activities and so on. At no time should he
be treated as an exception in respect to social responsibili-
ties or opportunities. Teacher and parent can cooperate
in enabling him to accept his disability as a challenge
which he can meet frankly and openly as he learns to
become secure in his use of hearing and lip reading.
There is a Chapter on Home Cooperation on page 107.

For Administrators:
Best, Harry, Deafness and the Deaf in the United States, MacMillan
Company, New York, revised, 1943. 675 p. $6.50.
Davis, Hallowell, Hearing and Deafness, Murray Hills Books, Inc.,
New York, 1947. 496 p. $5.00.
Mackie, Romaine P., "Deaf Children Under Six go to School." School
Life 30:5-8, January, 1948. Published by U. S. Office of Education,
Federal Security Agency, Washington 25, D. C.
Newhart, Horace, and Reger, Scott (Editors). Syllabus of Audio-
metric Procedures in the Administration of a Program for the Con-
servation of Hearing of School Children, American Academy of
Ophthalmology and Otolaryngology, 100 First Avenue Building, Roches-
ter, Minnesota, April, 1945. 29 p. Free.
For Teachers:
American Annals of the Deaf, (Proceedings of Conference of Execu-
tives of American Schools for the Deaf and American Instructors of
the Deaf), Gallaudet College, Washington, D. C. Five issues, $2.00.
Brentano, Lowell, Ways to Better Hearing, Franklin Watts, Inc.,
285 Madison Ave., New York, 1946. $1.00.
Ewing. Alexander W. G., and Ewing, Irene R. The Handicap of
Deafness, Longmans, Green and Company, New York, 1938. 388 p.
Ewing, Alexander W. G., and Ewing, Irene R. Opportunity and the
Deaf Child, University of London Press, London, England, 1947. (Secure
international postal money order for 9/6-about $1.90 in American
Hearing News, American Society for the Hard of Hearing, 1537-
35th Street, N. W., Washington, D. C. Twelve issues, $3.00.
Johnson, Wendell, and Others. Speech Handicapped School Children,
Harper and Brothers, New York, 1948. 464 p. $3.00 (Note Chapter VIII).
Journal of Speech and Hearing Disorders, The American Speech and
Hearing Association, c/o Speech Clinic, Wayne University, Detroit,
Michigan. Four issues, $3.50.
For Parents:
Keaster, Jacqueline, "An Open Letter to The Parents of a Hard of
Hearing Child." Journal of Exceptional Children 12:84-88, December,
Montague, Harriet, "Deafness-A Hazard and a Challenge." Children
Who are Exceptional, p. 27-29, National Congress of Parents and
Teachers, 600 South Michigan Blvd., Chicago, Ill. 1945. 50c.
Volta Review, The Volta Bureau, 1537-35th Street, N. W., Washing-
ton, D. C. Twelve issues, $2.00.


. .educational procedures are adapted to suit the needs of children
with partial vision.




Since eyes are the chief media for education, it is fre-
quently necessary to adapt educational procedures to
suit the needs of children with partial vision. These are
the children who because of a serious eye difficulty may
not succeed in school by use of the same educational
materials and physical facilities provided for the nor-
mally sighted child. On the other hand, they have too
much vision to read Braille and receive instruction
through the tactile sense.
The purposes of a class for the child with partial
vision are: (1) to provide the means of an education
with the least possible eye strain; (?) to teach him to
use efficiently the vision he has; (3) to provide learn-
ing experiences which aid the child to meet daily life
tasks and to participate as fully as possible in school
and home; and (4) to provide educational and vocational
guidance which will enable him to take his place in
A conservative estimate of the number of pupils need-
ing special education facilities for eye-work is one in a
thousand of the school population, but those long'experi-
enced in this field have found the proportion to be more
nearly one in five hundred. From these estimates school
authorities may determine the approximate number of
pupils in their county system needing this type of edu-

To determine definitely the need for a program for
children with partial vision in the county, the following
methods are suggested.
Teacher Observation: An alert teacher may be lihe
initial source for discovery of children who need eye
care. She should refer for further study all those who
are observed to have the following symptoms:


.1. The child attempts to brush away blurred mate-
rials, rubs eyes frequently, and frowns.
2. The child blinks more than usual, cries often, or
is irritable when doing close work.
3. The child stumbles frequently or trips over small
4. The child holds his book or small playthings far
away or too close to his eyes.
5. The child's ]body is very tense when looking at
distant objects.
6. The child is' sensitive to light.
7. The child is inattentive during reading instruc-
tion, map work, or blackboard work.
8. The child reads only briefly without stopping.
9. The child shuts or covers one eye when reading.
10. The child is restless and irritable concerning
school work.
11. The child is unable to distinguish colors.
12. The child tilts head to one side or leans forward
in order to see distant objects.
13. The child screws up face while reading.
14. The child displays frequent fits of temper.
15. The eyes are red-rimmed, or the eyelids are
swollen. i
16. *The eyes have repeated sties.
17. The eyes are watery or red.
18. The eyes are crossed.
19. The child complains of dizziness following close
20. The child complains of objects being blurred, or
apparently double.
Screening Procedures: Screening for visual defects
with each school in a county participating is an effec-
tive procedure, provided that it is done under correct
conditions. The State Department of Education in coop-
eration with the State Board of Health have agreed on
eye screening procedures to be used in the Florida

iSee Bulletin No. 4.


Two standard tests in common usage are the Snellen
E Chart and the Massachusetts Vision Test. The Snel-
len E Chart serves a useful purpose in detecting gross
defects. Failure to read the line designated on the chart
usually indicates visual deficiency, but success does not
insure the absence of deviation from the normal. Such
test does not detect, for example, faulty fusion of the two
eyes. With proper precaution, however, it serves admir-
ably for screening purposes in an inexpensive and- a
rapid manner.
The Massachusetts Vision Test is recommended by
some authorities, because it is a better means of identify-
ing far-sighted children and detects deviations from the
normal in fusion and in muscular balances. The results
from any screening test are only preliminary findings.
The child who fails the vision test must be referred for
an eye examination by an ophthalmologist.
In general the following are visual requirements for
the enrollment of a child in a class for the partially see-
1. Children having a visual acuity range between
20/70 and 20/200 in the better eye after correction
or treatment.
2. Progressive myopia when accompanied by patholo-
gical conditions.
3. Children with corneal opacities, irrespective of
vision, who are developing symptoms of ocular
4. Children suffering from diseases of the eye where
the condition is local, or which are the result of a
general disease or body condition, and where the
vision is seriously affected.
5. Since harmful psychological reactions may result
from eye difficulties, special educational facilities
may be necessary as a temporary measure for
readjustment as well as for educational processes
in the following cases: children who have had eye
operations, especially enucleations; those who are


cross-eyed or have other serious muscle imbalances,
when the crossed-eye is being re-educated and
occlusion of the good eye is necessary; those who
have recently suffered from childhood diseases such
as measles which may temporarily affect the eyes.

S. provide the means of an education with the least possible eye
Children who have been screened out for visual prob-
lems should be referred cooperatively by the school and
county health department to the parents for further
vision tests by an ophthalmologist. (For sample of
ophthalmological report form, see Appendix, page 133.)
After refraction, medical care, or surgical treatment
has been given, the children with partial vision are
recommended for special education and study.
Data concerning the following are necessary: (a) case
history of social and developmental background. (For
Case History Facts Outline, see Appendix, page 122); (b)
a report of a complete examination by a pediatrician since


some eye conditions are associated with disease and
general physical condition; (c) a school record; and (d)
report of an individual psychological test adapted to
the visual deficiencies and administered by a psycholo-
When the above data are available, a conference will
be held at which a county supervisor, the principal of
the school in which the class is located, the psychologist,
the ophthalmologist, and a representative from the
county health department will discuss the problems.
This group studies the reports previously made and
makes recommendations for the child's educational pro-
The Physician's statement of recommendation, case
history, and psychological study are filed in the Cumu-
lative Guidance Folder-Grades 1-12 in the principal's
office. The teacher should have easy access to these
records at all times. These reports are confidential to
be used only by the professional workers concerned
with the individual child.

The state law provides for Instructional Units of ten
exceptional children or less, if there is evidence to show
that the total number of children needing service is less
than ten. In some counties, there may be only seven or
eight for a class. In others, there will be ten or more.
The majority of classes for partially seeing children
will cover several grades in range. A class covering
three grades may accommodate as many as 16 pupils;
classes with more grades should be proportionately
Following enrollment in the class, each child should
have an annual re-examination of the eyes, or more often
if so specified on the opthamological report. The spe-
cial education teacher keeps a record of the pupil's edu-
cational, social, and health progress, which is sum-


marized for the cumulative record. She is always alert
to observe improvement in visual responses and the pos-
sibility of full return to the classroom. The final decision
for the child's permanent return should be made by the

Classes for partially seeing children are not needed
in all schools; therefore, a centrally located school build-
ing should be selected convenient to all transportation
Correct illumination and decoration are the first fac-
tors to be considered in preparing the room since good
lighting makes eye tasks easier. Natural and artificial
lighting may be used. Choice of room as to optimal light
exposure is essential. An artificial lighting system is ad-
vised to supplement natural light with provision for a
maintained minimum of 50 foot candles of illumination at
all times. The light should be well diffused and distri-
buted to all areas of the room without glare. There
should be fitting of window shades or venetian blinds
that are readily adjustable to light changes. Both illumi-
nation and harmony should be taken into consideration
in selecting room decorations such as color of walls,
ceilings, chalkboards, and color of other features.
The following equipment and supplies are essential:'
1. Seats and desks should be movable and adjustable
in regard to height, angle, and position. Desk tops
should be adjustable to any desired angle.
2. Soft black lead pencils and special pens should be
used so that the child will have little difficulty in
seeing his written work. Extra large soft, white
chalk should be used for all board work.
3. Unglazed cream paper, both unruled and ruled
with lines spaced in green %/" to 1" apart, as well
as classroom items such as drawing paper, crayons,
and paints for daily needs should be provided.
iMimeographed material on the subject of "Supplies and Equipment"
is available from the State Department of Education.


4. At least one typewriter, equipped with 24 (ampli-
type) and a type writing stand permitting correct
placing of material is needed.
5. Books printed in 24 point type, or 18 point type
(according to the age and eye difficulty of the
pupil) are suitable. These should meet accepted
specifications regarding spacing, contrast, size
and kind of type, illustrations and paper.
6. A phonograph is used for music and transcriptions
of literature of instructional content.
7. Maps and globes designed for children with partial
vision are available for purchase but are not a
priority essential.
8. A sound recording instrument is highly useful for
instructional materials prepared by the teacher.
The curriculum for a class of children with partial
vision should be planned to meet the individual poten-
tialities of each child. Partially seeing children, like all
children, need to have: (1) security; (2) social status;
(3) a feeling of success; and (4) the enjoyment of new
experiences. In general, children in classes for the par-
tially seeing should have the benefit of the curriculum
offered to the normally sighted with only those adapta-
tions that are necessary for their eye conditions.
Elementary Level: The placement of children in the
special education class does not relieve the classroom
teachers from sharing in the responsibility for the educa-
tion of these children. The child with partial vision
should be encouraged to associate and compete with his
normally seeing companions in activities not requiring
close use of the eyes. For the partially sighted child
a cooperative plan of classroom participation is manda-
tory by State Regulations. In such a plan pupils have
a daily and weekly schedule of attendance for certain
work periods in the existing classrooms. The cooperative
plan is a shared responsibility between the teacher of the
class for the partially seeing and the classroom teachers.


The child with partial vision should attend the class-
room with his companions for as many of the following
periods as are desirable for him, all things considered,
for discussions in social studies, physical education, (if
so recommended by the ophthamologist), music (rote),
oral arithmetic, oral reports, and school club work.
Whenever there is close eye work for reading, spelling,
arithmetic, writing, or studying, the pupils work in the
special education room. The academic skills are taught
in the latter room.
Where editions of standard texts in type suitable for
the pupils are not available, lessons from the regular
text must be read to the pupils. Emphasis is placed on
as much oral learning as possible. Activities which
do not require close eye work provide frequent periods
of eye rest necessary at various intervals of the day.
Teaching methods and techniques are applied according
to the child's eye condition. Typing instruction is a use-
ful tool for these pupils and instruction should be begun
as early as possible.
Eye hygiene and care of the eyes at home and at
school is a part of the program. Care of glasses also
is emphasized.
Secondary Level: For students with partial vision
in the junior high and senior high school, it may be desir-
able to establish classes based on the principles under-
lying those on the elementary level. In some instances
depending on the abilities of the child, his eye condition,
and the secondary school situation, the pupil may be
assigned to the existing school program with satisfactory
adjustments for his needs. Since the program in Florida
is still in the period of development, situations at the
high school level call for careful study and scheduling.
Careful attention should be given in selecting a schedule
of subjects on the basis of the eye-work required. The
success of the secondary school program depends largely
upon the wise choice of subjects and activities. The
interest of the high school counselor should always be


Whether or not classes for children with partial vision
are set up, pupils will need reading helps. Pupils with
normal vision may be used as readers, or readers may
be obtained through private or other resources. Mechani-
cal devices such as the talking book, typewriter, dicta-
phone, ediphone, radio, sound scriber (disc type), and
recorder are useful devices for making eye tasks easier
for the high school student.
The program should offer the student opportunities
for vocational guidance. Students of sixteen years of
age should be referred to the Vocational Rehabilitation
Service which offers valuable assistance to individuals
with physical limitations.
The success of the educational procedures, for both
elementary and high school pupils with partial vision,
depends upon the cooperation of the administrators and
the entire faculty of the school.
Children in Rural Schools Without A Special Educa-
tion Class: If there are rural children for whom facili-
ties in classes for the partially seeing cannot be arranged,
certain aids can be offered them. The teacher should
know the eye condition of such a child and obtain sug-
gestions for eye care from the ophthalmologist. These
children should be seated advantageously in the best
available light in the room (albinoes excepted). When
it is necessary to see the board, the child should feel free
to move in such a position that he can see readily. He
would need help in making small measurements.
Books with suitable type may be provided. Reader
services by some older child will also be of assistance.
Arrangements may be made for the use of the talking
book through the Florida Council for the Blind. This
phonographic device will supply many of the classics
and solve the problem of "required reading." Large
materials, paper, and pencils should be made available
to these children.


The teacher of a child of this type would benefit
by visiting a well equipped class for partially seeing
The young child three to six years of age who is blind
requires the same opportunities for developing his native
abilities as does any other child of his age group. The
nursery school provides a social environment for devel-
opment in motor, :In -ua.i,', and adaptive behavior'
which the child who learns from tactile and auditory
stimuli rather than visual so much needs.
According to the Florida Law a unit for young blind
children three to six years of age may be opened pro-
vided there are ten children who require such service.
There will probably not be in any one area in Florida
sufficient number of exceptional children who meet the
requirements. It is likely, therefore, that the child will
attend nursery school with normally sighted children.
In such case, the nursery school teacher will need assist-
ance in planning for his orientation to a group situation
and for his use of equipment and materials of social and
educational value. Popular with the blind child are small
playthings with characteristic shape or sound and large
moving toys such as the rocking horse, see-saw, or swing.
Planned play experiences and associations will give out-
let for normal childish eniitriy and prevent formation
of undesirable habits or "blind mannerisms" such as
walking in circles, tilting the head in unnatural posi-
tions to look at the light, or tapping on objects to pro-
duce sounds. The continuous repetition of normal child-
hood activity has an irresistible influence for construc-
tive habit formation similar to that of his group asso-
Meeting the needs of the young blind child is largely
a responsibility of the family. Parents faced with car-
ing for a blind child often find the task a very difficult
one and sometimes are over-protective. Close coopera-
'See Bulletin No. 53


tion between the school and family is essential so that
both can work toward normal development of the child.
If the family needs guidance, referral should be made to
the Florida Council for the Blind.

For Administrators:
Hathaway, Winifred, Education and Health of the Partially Seeing
Child. Columbia University Press, New York, revised, 1947. 216 p. $2.50.
American Standard Practice for School Lighting (A-23), Illuminating
Engineering Society, 51 Madison Ave., New York, 1948. 79 p. 50c.
For Teachers:
A Graded List of Books for School Libraries. (Books in large type
noted.) Harcourt, Brace and Company, New York. 1948-49. P. 55.
Eye Health, A Teaching Handbook for Nurses, National Society for
the Prevention of Blindness, Inc., 1790 Broadway, New York, 1947.
Publication No. 447. 108 p. 60c.
Fox, Sidney A., Your Eyes, Alfred A. Knopf, New York, 1944. 191 p.
Hathaway, Winifred, Education and Health of the Partially Seeing
Child, Columbia University Press, New York, revised, 1947. 216 p. $2.50.
Hathaway, Winifred, Easy on The Eyes, John C. Winston Company,
1947. 88 p. $1.50.
Matson, Charlotte and Wurtsburg, Dorothy. Books for Tired Eyes. A
List of Books in Large Print, American Library Association, Chicago,
Ill., revised 1940. 80 p. 65c.
Sight Saving Review, National Society for the Prevention of Blind-
ness, 1790 Broadway, New York. Four issues, $2.00.
For Parents:
Hathaway, Winifred, Children Who are Exceptional, p. 14-18, Na-
tional Congress of Parents and Teachers, 600 South Michigan Blvd.,
Chicago, Ill. 1945. 63 p. 50c.
Schwartz, Louis H., Your Eyes Told Me, E. P. Dutton and Company,
Inc., New York, 1945. 208 p. $2.75.
Large Print Books:
The following companies publish books in large print for children:
American Printing House for the Blind, 1839 Frankfort Avenue,
Louisville, Ky.
Clear Type Publishing Committee, Pompton Lakes, N. J.
Harcourt, Brace & Company, 383 Madison Ave., New York 17, N. Y.
Stanwix House, 336 Fourth Ave., Pittsburgh 22, Pa.
John C. Winston Company, 1010 Arch Street, Philadelphia 7, Pa.
Pre-School Blind Child:
Lowenfeld, Berthold, The Blind Pre-School Child, American Founda-
tion for the Blind, Inc., New York, 1947. 148 p. $2.00.
Van den Broek, Gertrude, Guide For Parents of a Pre-School Blind
Child, Commission for the Blind, New York State Department of Social
Welfare, 205 East 42nd St., New York, 1946. 48 p. 15c.



S. .the makings of a successful adjusted adult.






The crippled child is defined for us by the Florida
Crippled Children's Commission as follows:
"Any person of normal mentality under the age of
twenty-one years whose physical functions or move-
ments are impaired by accident, disease, or congeni-
tal deformity, regardless of whether or not such
impaired physical functions or movements are due
to an orthopedic condition; it shall include children
suffering from any disease or condition which is
likely to result in a crippling condition."'
The term "crippled" is a broad one used to denote a
heterogeneous group composed of those having: cerebral
palsy, conditions resulting from infections such as polio-
myelitis, osteomyelitis, and tuberculosis of the bone, con-
genital anomalies such as club feet or hip dislocation,
traumatic condition, muscular dystrophy, and miscellan-
eous conditions such as scoliosis, Erb's palsy, spinal
bifida, fragile bones, or tumors.

Cerebral palsy is one of the commonest causes of crip-
pling in children. It is described by Dr. Winthrop
Phelps,2 noted medical specialist as
"... a disability of the nerves and muscles caused
by damage to certain centers of the brain that govern
muscular control. When the centers of learning and
intelligence escape this damage, the afflicted person
will have all his native intelligence, even though his
strange facial contortions, speech impediments, and

.1Florida Crippled Children's Commission Biennial Report, 1945-1947,
Florida Crippled Children's Commisison, Tallahassee, Florida, p. 5.
2Winthrop M. Phelps, "The Farthest Corner," The National Society for
Crippled Children and Adults, Inc., Chicago 3, Ill., 1947. p. 3.


difficulty in writing might make him appear to the
uninformed person as a mental defective."
Infantile Paralysis resulting from pollomyelitis is
a common cause of crippling and one of the most feared.
The early symptoms are similar to many childhood dis-
eases. Poliomyelitis may or may not cause crippling. The
precise method of the spread of the disease is undeter-
Today there is a brighter future for the child who has
had infantile paralysis because of better methods of
treatment. Early diagnosis and systematic medical fol-
low-up are extremely important. Physical therapy and
occupational therapy are essential parts of most treat-
ment programs. Since the. exact cause of poliomyelitis
is not known, methods of prevention cannot be deter-
Osteomyelitis was for many years a rather frequent
cause of crippling. Because of more effective methods of
treatment this condition has been greatly reduced.
"Osteomyelitis means inflammation of the bone mar-
row: the term is commonly used, however, to des-
ignate an infection of bone by one of the common
pus-forming bacteria ... Any bone in the body may
be involved by osteomyelitis. The ones most fre-
quently affected, in the order of their frequency, are
those of the leg, thigh, arm, and forearm."2
Bone and joint tuberculosis is still a serious condition,
although the incidence of crippling due to tuberculosis
is much reduced. The child who is suffering from this
disease should be guarded from injury and taught to
avoid fatigue and overexertion. In order to live a life
adjusted to his limitations he should develop good sleep-
ing and nutritional habits and realistic attitudes.

iThe National Foundation for Infantile Paralysis gives advice about
precautions to be taken. See The National Foundation for Infantile
Paralysis, 120 Broadway, New York 5, N. Y., Publication No. 51, April,
2Raney, Richard A., and Shands, Alfred R. "The Prevention of De-
formity in Childhood," The National Society for Crippled Children,
Chicago, Ill. 1941. p. 10.


Congenital anomalies or abnormalities express them-
selves in many ways and are relatively common crip-
pling conditions.
"Little is known about the causes of congenital
anomalies The old idea of prenatal impressions,
that events seen or dreamed of by the mother can
result in abnormalities of the child has been com-
pletely discredited.'"
Traumatic conditions include crippling injuries result-
ing from accidents and burns. Many of these cases will
perhaps require the services of special education classes
for a time.
There are many other serious crippling conditions
which occur less frequently. Among these are: spinal
curvatures (such as scoliosis), muscular dystrophy, Erb's
palsy, spinal bifida, fragile bones, tumors, postural foot

The exact number of children with crippling condi-
tions in the United States is not known. It has been esti-
mated that "somewhat more than one per cent of chil-
dren of school age suffer from orthopedic or other crip-
pling defects."2 Probably not more than one-third of
these boys and girls will be so disabled as to need spe-
cial education classes although many of them will require
adjustments in their educational program.
In the one area of cerebral palsy alone, the problem is
now known to be much more extensive than was ori-
ginally believed to be true. Dr. Winthrop Phelps esti-
mates that an average of four educable children with
cerebral palsy are born annually to every 100,000 of
the population.3

1Ibid. p. 2.
2Martens, Elsie H., "Needs of Exceptional Children," U. S. Office of
Education, Washington, D. C., 1944. p. 3.
sPhelps, Winthrop M., "The Farthest Corner", National Society for
Crippled Children and Adults, Inc., Chicago 3, Illinois, 1947. p. 10.


The first step in a program for children with crippling
conditions is to find them. Several official agencies
share the responsibility. Among them are the public
schools, the state, county and local departments of health,
the Crippled Children's Commission, and the state and
county departments of public welfare. The school as
the one agency which is responsible for all children can
serve as a clearing house for finding those in need of
special health attention. The public schools have a legal
and moral responsibility for reporting crippled children.1
In the coordinated plan for public agency services, the
county health units and departments of public welfare,
in cooperation with schools, are active in locating and
clearing the needs of crippled children ant" in referring
such children to state and resource agencies.
The Crippled Children's Commission is the official
agency for administering services to crippled children.
This commission is a separate state department and has a
special responsibility since it operates under a Federal
Grant-in-Aid-Program made possible by the Social Se-
curity Act of 1935. The commission maintains a register
of children with crippling conditions, holds clinics, se-
cures hospitalization, provides physical therapy, makes
referrals of children to the public schools, and renders
other related services. The commission accepts any child
amenable to treatment but cannot, for example, serve the
extreme cerebral palsy child who cannot respond to treat-
ment. This agency, together with departments of health,
is one of the best sources for finding children who are
in need of special education.
In addition to the official agencies, there are other'
sources through which children can be found. Parent-
Teacher Associations, the Florida Chapter of the Na-
tional Society for Crippled Children and Adults and
similar groups, service clubs, and individual citizens, all
help in the difficult process of locating these children.

iSee Chapter IV, "Records and Reports." page 15.


Many boys and grls are still concealed in their homes
receiving neither public education nor health care. Every
citizen has a responsibility to rectify this condition.

Every American child is entitled to public education
but, because of certain physical disabilities some will
not be able to take advantage of this opportunity unless
special education classes and other educational adjust-
ments are available.
Any one may refer a child needing services. Children
with crippling conditions will then be checked by pedi-
atric and orthopedic physicians who may recommend
them for special education placement. The department of
health, the clinics of the Crippled Children's Commis-
sion, private physicians, hospitals, and other medical
centers, may all recommend the children.
Educational evaluation is also necessary. Such an eval-
uation includes psychological tests, teacher reports, anec-
dotal records, and other pertinent data. The staff con-
ference is the ideal technique for such evaluation. Wher-
ever conferences can be extended to include parents, the
understanding of the child's problem will be increased.
Regardless of the length of time spent in a special
education class in the day school, hospital, or in the home,
the child should be transferred back to an existing class-
room group just as soon as his need for the special edu-
cational adjustment has passed. When the physician in
charge states that the child has made sufficient physical
improvement, steps should be taken to facilitate his
return to the classroom.
When the child is ready for transfer out of the spe-
cial education class it is the specific duty of the teacher
to interview the parents concerning any problem of
adjustment to the new school. In addition, the teacher
should arrange for a conference with the principal of the
school which the child will enter to discuss the meas-


ures necessary to facilitate the adjustment of the child.
The cumulative school record folder containing copies
of all data relative to the case should be passed on to
the principal.

Many plans and several types of school organization
are needed to meet the changing needs of these children.
Large numbers of boys and girls are in elementary and
secondary day schools, either in existing classroom groups
or in special education classes; some are in hospitals and
convalescent homes; relatively few are so disabled that
they are bedfast or home-bound. Under the Florida State
Program for Exceptional Children it is possible for the
public school to provide education for the child wherever
he is found. A typical example of the manner in which
this program may operate follows:
Billy enters school, a normal, happy, six-year old.
His first grade experience delights him. He is inter-
ested in school and neighborhood activities. Soon
after his vacation begins he is stricken with polio-
myelitis. He is hospitalized in a polio ward and later
sent to the crippled children's hospital. His mother is
distressed over his paralysis and his need for adjust-
ment to his disability. She is concerned, too, abou'
his schooling which she fears will be interrupted.
While working with the physical therapist and learn-
ing to care for Billy's needs, the mother discovers
that a qualified public school teacher is employed
by the local board of education to carry on school
work in the hospital and in the convalescent home.
Billy eventually returns to his home, equipped with
braces and the ability to use them. To his delight
he discovers that there is a class for children with
crippling conditions in his own elementary school
where he can pick up the threads of his school work.
This class affords him needed services such as physi-
cal therapy, transportation, and individual equip-


ment. He finds no trouble in fitting into the activi-
ties of the group.
Later on his periodic medical check-ups at the hos-
pital point to the need for an operation, which is
taken care of during a summer vacation period. Fol-
lowing the operation he is confined to his home for
a number of weeks. When school opens in Septem-
ber, a teacher comes to his home in order to bridge
the gap in his education between his recovery and
his return to his school group.
Although Billy, now in high school, still has some
disability as a result of poliomyelitis, he is progress-
ing in a commercial course. Before Billy chose this
course the guidance counsellor of the school arranged
conferences for him with the Vocational Rehabili-
tion Representative who, in turn, helped Billy chart
his courses in order that he might become a happy,
well-adjusted adult, prepared to take his place in
society and equipped to earn his living.1
Billy is one of many Florida children who, while they
are under medical care, need this very type of public
education in day schools, hospitals, convalescent homes,
or in their own homes.
Day School Classes: There is a trend today toward
including classes for crippled children in the elementary
and secondary school building. When these units are a
part of the regular school, adequate provisions are to
be made for them.
Physical Plants: If a new school plant it to be con-
structed certain special features such as large class
rooms, physical therapy rooms, ramps, hand rails, and
indoor space for rest, relaxation, and play should be
When these classes are housed in the present build-
ings, it is often necessary to remodel them if they are
to serve adequately the needs of the group. The class-
'See Vocational Rehabilitation Services page 29.


rooms should be larger than the average room in order
to allow for wheel chairs, braces, crutches, specially built
seats, and desks. They should be easily accessible to
exits, toilets, drinking fountain, and lunchroom. They
should be adjacent to physical therapy and cot rooms
insofar as practicable. Because much of the equipment
is cumbersome and out of use temporarily, generous
storage space should be provided in the interest of
economy and efficiency.
The floors should be made of materials which will
prevent slipping. The corridors'and halls which are
used regularly by these children should be widened and
provided with hand rails so that the child may walk
with as little assistance as possbile. Entrances and exits
should be provided with ramps.
Equipment: In purchasing equipment, security, eom-
fort, and sometimes therapeutic values are the objec-
tives to be considered. The child with cerebral palsy,
for example, often needs individual equipment much of
which should be purchased only on the recommendations
of physicians and therapists. It is therefore advisable
to wait until enrollment of the pupils for purchase of
this specialized equipment, much of which may be made
by parents, high school shops, vocational schools, or by
contributed services of labor organizations.1
Nutrition and Rest: The lunch time is a part of the
day that will need careful planning. Most of the chil-
dren are transported and they need a nourishing
meal at noon. Extra food may be needed, too, for some
of these children who expend a great deal of energy. This
is especially true of the athetoid type of cerebral palsied
child. A pleasant learning situation can be made out of
each mealtime experience.
Some children will require more than one rest period
each day. Cribs, cots, or pads with washable covers,
linens, and blankets are desirable equipment. The room
1Mimeographed material on the subject of "Equipment and Supplies"
is available from the State Department of Education.


used for rest should be cheerful and comfortable. Music
played softly will make this period an enjoyable time
for the children.

.. toward the development of the individual.

"The school curriculum should be directed toward
the development of an individual who assumes increas-
ing responsibility for self-direction and for the develop-
ment of his potentialities in such a way as to bring about
optimum satisfaction both to himself and to society."'
The philosophy of instruction for the child with phys-
ical problems is the same as that for the so-called nor-
mal child; however, because of physical limitations or
the conditions resulting from such limitations, it is often
difficult to arrive at these goals. For this reason the
instructional program for crippled children in both the
existing classroom and special education class usually
offers certain services such as an intensified health pro-
gram and h flexible individualized curriculum.
Most children with orthopedic conditions need an
enriched program of instruction, as many have had long
periods of hospitalization, confinement at home, limited

ISee Bulletin No. 9


travel, meager social experiences, and little opportunity
to observe the world in general.
One hospitalized eleven-year-old boy was quite a
talented art student; he was encouraged to develop his
ability in drawing. His work was predominantly pic-
tures of the sea or seashore. Upon questioning, it was
discovered that, although living for three years in a hos-
pital situated just fifteen miles from the Atlantic Ocean,
he had never seen the sea.
Common, everyday experiences are novel to some chil-
dren who have been hospitalized in early life. Children
have been found in hospitals who did not know the use
of an umbrella, have never seen a raw carrot, did not
know what a stove looked like, or were too frightened to
talk on the telephone. It is the teacher's responsibility
to provide situations which will give the child enriched
experiences in living, academic work, music, art, and
simple crafts.
The curriculum in the school provides not only for
intellectual development, but also offers specialized
health facilities. The work of the physical and occupa-
tional therapist is closely related to the school program.
The services of the teacher and the therapist are inter-
meshed. The therapist is often able to suggest devices
which enable the child to use crayons, pencils, and paints
in purposeful activity which will contribute to physical
In the curriculum of the special education class, prog-
ress should be measured in terms of the individual's own
capabilities. Children cannot always give back in writ-
ing or intelligible speech evidence of what they have
learned. However, learning does go on and often can
be observed by the discerning teacher.
One six-year-old hospitalized child with cerebral palsy
could not say what it was that disturbed her but she
showed great concern. After much effort on the part of
several teachers and children, it was discovered that
the child was disturbed because her teacher seemed to


be catching cold. The little girl wanted the teacher to
use nose drops like the nurse usually gave her.
Even though the program of instruction for children
with crippling conditions is highly individualized, social
development is not overlooked. In hospital classes and
special education classes in schools, a social atmosphere
prevails. Many of the activities are of common interest
to the group. Opening exercises, group planning, social-
ized recitations, and club meetings which would be found
in any classroom make up a typical school day.

Th.e emotional development of the child with crippling
conditions is one of the highly important phases of his
educational program. One factor to be remembered is
to help him objectify his attitude toward his physical
problems. By indirect guidance he may be made to feel
that it is not an unmentionable subject; nor, at the other
extreme, should it be a never-ending topic of conversa-
tion. The clever child may rely on his condition to make
his tasks easier. The youngster who looks at his teacher
with a pleading, sympathy-demanding expression in his
eyes and yet, with a twinkle, and says, "Please, teacher,
you're not going to give all that work to a poor little crip-
pled boy, are you?" is certainly a youngster with a fine
sense of values. He has a realistic attitude toward his
disability; he can treat it with humor; he is not a "poor
little crippled boy" and he knows it. He is a child who
has the makings of a successful, adjusted adult, if his
energies are correctly directed and an underlying ambi-
tion for success is instilled in him.
Enabling the child to realize that his difficulty is not
unique, may have a therapeutic value. Guidance in the
realization that he is not the only individual with a dis-
ability is the teacher's responsibility.


Florida has recognized the importance of educational
programs for young children who have physical limita-
tions. Forward looking legislation was enacted in 1947
whereby financial aid could be given to local public
schools to maintain classes with enrollments of ten for
young children with cerebral palsy between the ages of
three and six. Children with this condition profit by
such classes, especially when a program of physical and
occupational therapy is an integral part of the pre-

Some parents know little or nothing about cerebral
palsy; many are frustrated in planning for the child's
future. Frequently they overprotect him, in other in-
stances such a child is rejected. Quite often the parents
fail to encourage self-help habits. It is in this pre-
school period that walking, talking, eating, dressing, and
independent toilet habits are learned. It is encouraging
to note the many cerebral palsied children who begin
feeding themselves, walking, talking, and otherwise
acquiring independence when they are in a classroom
For Administrators:
Hoyer, Louis P., and Hay, Charles K. Services to the Orthopedically
Handicapped, Philadelphia Board of Education, 21st St. and Parkway,
Philadelphia, Pa., 1942. 115 p. 50c.
Report of the Sub-Committee on Orthopedically Handicapped Chil-
dren, Board of Education of the City of New York, New York, 1941.
141 p.
Turner, T. Arthur, Organizing to Help the Handicapped, National
Society for Crippled Children, Inc., Elyria, Ohio, 1944. 165 p. 50c.
For Teachers:
Barker, Roger G., Wright, Beatrice A., Gonick, Mollie R. Adjustment
to Physical Handicap and Illness: A Survey of the Social Psychology of
Physique and Disability, Social Science Research Council, 230 Park
Avenue, New York 17, N. Y., Bulletin No. 55, 1946. 372 p. $2.00.
Fitzgerald, Margaret A., "A Volunteer 'First-Aid' to Education," The
Crippled Child, 21:92-98, December, 1945.
Mackie, Romaine P., Crippled Children in School, U. S. Office of
Education, Bulletin No. 5, Government Printing Office, Washington.
D. C., 1948. 37 p. 15c.
Phelps, Winchrop M., "The Farthest Corner," National Society for
Crippled Children and Adults, Inc., 11 South LaSalle St., Chicago, Ill.,
1947. 23 p. 10c.


Shands, Alfred R., Handbook of Orthopedic Surgery, The C. V.
Mosby Company, St. Louis, Mo., 1940. 587 p. $6.00.
The Crippled Child, National Society for Crippled Children and
Adults, 11 South LaSalle Street, Chicago, Ill. 24 issues. $2.00.
For Parents:
Gratke, M. Juliette,,Help Themn Help Themselves, Texas Society for
Crippled Children, 3703 Worth, Dallas, Texas, 1947. 176 p. $2.50.
Mackie, Romaine P., Information for Parents of Cerebral Palsied
Children, State Department of Education, Sacramento, California, 1948.
20 p. Free.
Shaw, Marcia G., You Can Help Your Child, Detroit Othopedic
Clinic, Detroit, Michigan, 1945. 14 p. 26c.




In addition to those who have visual or hearing losses,
or those who have crippling conditions, there are a large
number of children with special health problems. The
causes for such health problems are many. Common
among those are cardiac disabilities, asthma, diabetes,
epilepsy, allergy, and malutrition.
Most of the children with such conditions will be
enrolled in the classrooms of the public schools and many
of these will make very satisfactory progress in these
groups. Some of these children, on the other hand, will
need special education classes, individual adjustments,
and guidance if they are to take advantage of public
school education. For a discussion of provisions which
in many instances are similar to those relating to the
education of children with special health problems, note
the preceding chapter entitled "Children with Crip-
pling Conditions."
Children with Cardiac Disabilities: Most of the school-
age children with cardiac disabilities have had rheu-
matic fever. It is estimated that at least 90% of the


. .an enriched program of instruction.


cardiac disabilities in children result from this cause.
The needs of these children are so varied and so chang-
ing that each one should be individually considered. In
terms of the physical condition of the child, the physi-
cian decides whether the child can remain in the class-
room with minor adaptations, enter a special education
class, or receive home instruction. When physical
limitations are necessary the physician specifies the
nature of such limitations. Some of these children require
a long period of convalescence. Physicians today are
becoming more and more aware of the need for the all-
round development of children while they are in hospi-
tals and convalescent homes. It is realized that a medi-
cal and health program is not enough, for without edu-
cation and opportunity for social experiences, whole-
some personality growth is hindered even though physi-
cal improvement may be taking place. The needs of
children confined to hospitals and convalescent homes
for long or short periods of time present a major chal-
lenge. Many boys and girls with cardiac disabilities will
be so confined and it is important that the public schools
provide for their education during their stay in these
Children with Diabetes: Most diabetic children will
be enrolled in existing classrooms, but it is important
that every teacher understands something about the
nature of this disease so that she will be prepared to
help the child.
Diabetes is a disease' where there is a deficiency of
insulin in the body and most cases will require addi-
tional insulin by injection. This disease is usually more
serious in younger individuals than in older people. With
careful attention to the intake of food containing carbo-
hydrates and to the proper amount of insulin taken, most
children with diabetes can live fairly normal lives. If
the amount of insulin taken is in excess of the bodily
needs, a condition known as insulin shock will occur,
the symptoms of which are pallor, cold clammy perspira-
tion, nervousness, weakness, and mental confusion. The
1Diabetes Mellitus, (leaflet), U. S. Public Health Service, Washing-
ton, D. C.


teacher should be quick to recognize these symptoms
and should immediately advise the parent. Early in the
school year teachers should be informed who is a dia-
betic. The teacher of a child with diabetes should confer
with the child's parents or the family physician so that
she may know the requirements of each child. The gen-
eral health of these children should be watched very
carefully, especially in regard to taking colds.
Children with Epilepsy or Convulsive Disorders: Re-
search in the causes and treatment of epilepsy in recent
years has resulted in improved techniques and more
effective medication for diagnosing and treating epileptic
conditions. Because convulsions may take a variety of
forms and be related to a number of factors, many physi-
cians today use the term "convulsive disorders" and
"convulsive" in preference to "epilepsy" and "epi-
leptic."' Under present methods of medical treatment,
more children than formerly can be satisfactorily ad-
justed in home life and in school life.
In the past many children with this condition have
been excluded from school. A doctor's statement to the
effect that the child was subject to convulsive seizures
made it possible for many children to be withdrawn from
school, regardless of their intellectual ability or their
social and emotional needs. Even today, too many chil-
dren are excluded after the first seizures in the classroom.
It has been estimated by some authorities that the
seizures of three-fourths of the children having convul-
sive disorders can be controlled. In planning for such
children the first step is careful medical examination.
Every child who is recognized as having a convulsive dis-
order should be under the care of a physician. Undoubt-
edly, there will be some children whose seizures are so
frequent and so uncontrolled that it is necessary for them
to be relieved of school work or in some instances to
receive instruction at home. On the other hand, many of
iBradley, Charles, "Management of the Convulsive Child." reprint by
American Epilepsy League, 130 North Wells Street, Chicago 6, Ill., 1946.

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