These simple tests will serve to determine whether the child has, or has not, a normal acuteness of hearing.  They will not serve to determine with any accuracy the degree of impairment, if it is found that the hearing is impaired at all.  More thorough tests will have to be postponed till the child is two years old or more.  But the moment that impaired hearing is suspected, the best available ear specialist should be consulted in order to determine whether the cause can be removed, or measures taken to prevent a progressive increase in deafness.

The visit to the otologist should be repeated at intervals of not more than eight or ten months, even where there is no question of treatment, in order that any change in the physical condition of the organs may be promptly detected.

III

HOW SHALL THE MOTHER GET INTO COMMUNICATION WITH HER DEAF CHILD?

Let it be assumed that when the child is fifteen months old it is fairly well established that his hearing is somewhat below normal.  Between fifteen months and two years of age all that is said in this section will apply equally to the child who is feared to be totally deaf and to one who is known to possess some sound perception, though not a normal degree of hearing.  For, until he is old enough to respond to more complete and accurate tests, we must not give up the idea that he may have a sufficient remnant of hearing to be of great assistance to him in the acquisition of speech and language, if it is only developed and trained.

Between the ages of twelve months and twenty-four months the child with perfect hearing makes rapid progress in learning to understand what is said to him, and by the time he is two years old has usually begun to speak many words and sentences in a more or less imperfect way.  This has been accomplished principally by the mother’s constant talking to her baby.  If she has had the good sense to always speak in simple but complete sentences, and to avoid the foolish “baby talk” unfortunately affected by some people in addressing little children, the results of her daily and hourly talk is the possession by the child of a considerable vocabulary of words whose meaning he knows, and a less number that he is able himself to speak in a rather imperfect way.

In what respects should the mother modify her treatment of the baby if she suspects that his hearing is defective?  She should not talk to him any the less on this account, but, on the contrary, she should talk to him more.  She should, however, speak a little louder, a little nearer to him, possibly a little more slowly and distinctly, exercising the greatest caution, however, not to exaggerate speech into unnatural facial contortions, or to accompany it by gestures.  To fall into the habit of mouthing and gesticulating, making faces and motions, will defeat entirely the purpose of all efforts to develop an understanding of speech by the child.  Unfortunately, such exaggerated and absurd speech is a natural and very prevalent fault.  To avoid it is absolutely necessary, but requires constant watchfulness, as there is a strong temptation to try to make speech-reading easy for the child by opening the mouth wide and making extraordinary movements of the tongue.