I I I ‘°“ I 01$ 00'! .THS_ A COMPARATIVE $TUDY OF THE HEARING PROFICIENCY OF CHILDREN IN A BOYS VOCATIONAL SCHOOL AND IN A PUBLIC SCHOOL Thesis for Ike Degree OI M. A. MICHIGAN STATE UNIVERSITY Francis Harold Tokay 196-2 1.0 T Ir Pb: III.‘ ABSTRACT A COMPARATIVE STUDY OF THE HEARING PROFICIENCY OF CHILDREN IN A BOYS VOCATIONAL SCHOOL AND IN A PUBLIC SCHOOL by Francis Harold Tokay The purpose of this study was to determine whether any signif- icant differences exist between the auditory thresholds of a sample of juvenile delinquents from a training school and a group of boys attending a public high school. The subjects participating in this study were sixty-two juvenile delinquents from the state Boys Training School in Lansing, Michigan, and sixty-two boys from a public high school in Holt, Michigan. Each subject was given a pure-tone air conduction hearing test. A portable audiometer (Beltone, Model: 100) was utilized in administering the tests. The findings of this study tend to indicate that there is no real difference in the over-all hearing acuity between the group of delinquent and non-delinquent boys. It would appear then, that from these results one could not suSpect hearing level to be an important etiological factor in juvenile delinquency. chmféiio 61/7); 61572 (02/ A COMPARATIVE STUDY OF THE HEARING PROFICIENCY OF CHILDREN IN A BOYS VOCATIONAL SCHOOL AND IN A PUBLIC SCHOOL By Francis Harold Tokay A THESIS Submitted to Michigan State University in partial fulfillment of the requirements for the degree of MASTER OF ARTS College of Communication Arts, Department of Speech 1962 LIST OF Chapter I. II. III. IV. TABLE OF CONTENTS TABLES STATEMENT OF THE PROBLEM Introduction Statement of Problem and Purpose of Study . Hypotheses . Importance of Study . Definition of Terms . REVIEW OF THE LITERATURE Development of Hearing Tests Method of Testing . . Reliability of Testing Procedures . Selection of Specific Procedures. Effects of Ambient Noise . Effects of Other Extraneous Factors . SUBJECTS, EQUIPMENT, AND TESTING PROCEDURES . Subjects Equipment . Procedure . RESULTS AND ANALYSES Introduction Analyses . Discussion of Results . SUMMARY AND CONCLUSIONS . Summary . Conclusions . BIBLIOGRAPHY APPENDICES ii Page iii \1 UI-L‘ri-I H Hoooooxl I—IH 12 12 13 16 16 16 21 ‘ 23 23 24 26 28 LIST OF TABLES Table 1. Mean Composite Threshold Scores for Both Ears of Each of the 62 Subjects from Holt High School and Boys Training School and the Calculations Employed in the Determination of the Pearson Product Moment Correlation Coefficient . . . 2. The Difference Between the Mean Threshold Scores for Both the Right and Left Ears of Subjects in Each of Four Age Groups from Holt High School and Boys Training School Expressed as Efscores Together with the Standard Deviations for Both Groups . . . . . . . . . . . . . iii Page 17 20 CHAPTER I STATEMENT OF THE PROBLEM Introductioni Juvenile delinquency has been of social interest and con~ cern for many years. Our society has recognized this problem and has approached it from many different directions, the ultimate goal being the eradication and prevention of this social debility. One approach to the problem of juvenile delinquency has in- volved the attempt to isolate those factors which may be of etio- logical significance. A survey of the literature indicates that several physical characteristics, which may be related to the occurrence of juvenile delinquency, have been investigated. Glueck feels that there is a positive relationship between juvenile delin- quency and body build.1 Boys with solid body builds, or mesomorphs, tend to be vigorous, assertive, and have been found to relieve their tensions by means of physical activities. According to Glueck, these characteristics indicate a high "delinquency potential," be- cause, if their energies are not channeled toward socially accept- able goals, these boys may seek antisocial outlets.2 In another study, Gill found a positive relationship between the physical 1[Dr. Sheldon Glueck], "Body build is a clue," Science News Letter, Vol. 70, (October 6, 1956), p. 212. 2[Dr. Sheldon Glueck], "Type and Temperament," Newswgek, Vol. 48, (September 24, 1956), p. 105. 1 2 condition of strabismus cm'"crossed eyes," and juvenile delin- quency.3 According to Gill, the child with strabismus often suffers ridicule, and for this reason he often quits school. This may even lead to the development of an inferiority complex or some kind of psychic trauma. NumErous other studies dealing with those physical charac- teristics which may be of etiological significance in the occurrence of juvenile delinquency appear in the literature. Each study has attempted to contribute some information that may help our society ultimately to reach its goal of eradicating and preventing juvenile delinquency. In the study that follows, still another character- istic which may be related to juvenile delinquency is investigated, viz., hearing acuity. Statement of Problem and Purpose of Study This study will attempt to determine whether any significant differences exist between the auditory thresholds of a sample of juvenile delinquents from a training school and a group of boys attending a public high school. Sixty-two boys, randomly selected from those attending Boys Training School (in Lansing), will serve as members of the eXperimental group. For purposes of comparison, these individuals will be matched, according to age, with sixty-two boys attending Holt High School. In order to investigate possible differences in hearing 3[Dr. E. G. Gill], "Crossed Eyes Can Lead to Juvenile Delinquency," Science News Letter, Vol. 71, (February 23, 1957), p. 120. 4Ibid. 3 acuity between these two groups, the mean composite auditory thresh- olds of the experimental group will be compared with those of the control group for frequencies of 250 through 6,000 cycles per second.‘ In addition, the auditory threshold of each individual in the experimental group will be compared with that of his matched counterpart for both ears at the above mentioned frequencies. Also, a comparison between the composite means of each ear will be made for each of the four age groups. Again the frequencies of concern will be 250, 500, 1,000, 2,000, 4,000 and 6,000 cycles per second. Hypotheses In examining the relationship between auditory acuity and juvenile delinquency the following null hypotheses have been pro- posed: 1. There is no relationship between the mean composite auditory thresholds for all frequencies of the total sampled population at Boys Training School and Holt High School. 2. There is no significant difference between the mean auditory thresholds of the gighg ears of fourteen year old subjects at Boys Training School and Holt High School. 3. There is no significant difference between the mean auditory threshold of the lgfg ears of fourteen year old subjects at Boys Training School and Holt High School. 4. There is no significant difference between the mean auditory thresholds of the right ears of fifteen 4 year old subjects at Boys Training School and Holt High School. 5. There is no significant difference between the mean auditory thresholds of the lgfg ears of fifteen year old subjects at Boys Training School and Holt High School. 6. There is no significant difference between the mean auditory thresholds of the EIEEE ears of sixteen year old subjects at Boys Training School and Holt High School. 7. There is no significant difference between the mean auditory thresholds of the lgfg ears of sixteen year old subjects at Boys Training School and Holt High School. 8. There is no significant difference between the mean auditory thresholds of the Eight ears of seventeen years old subjects at Boys Training School and Holt High School. 9. There is no significant difference between the mean auditory thresholds of the lgfg ears of seventeen year old subjects at Boys Training School and Holt High School. Importance of Study In an attempt to attain the goal of prevention and eradica- tion of juvenile delinquency many factors must be investigated. It is only through the continual contribution of information an advance- ment can be made in the understanding of such a problem. The 5 substantiation of information already obtained is important, but more so is the addition of new knowledge. A personal survey of the literature has indicated that no formal study has been concerned with the possible relationship between hearing acuity and juvenile delinquency. The writer feels that, if the results of this study indicate a positive relationship between hearing acuity and the occurrence of juvenile delinquency, it may serve to emphasize the need for early diagnosis of hearing impairments, early treatment, and early educational planning. Definition of Terms Decibel: The decibel is a unit of level which denotes the ratio between two quantities that are proportional to power; the number of decibels corresponding to the ratio of two amounts of power is ten times the logarithm to the base 10 of this ratio.5 Composite Threshold: A threshold which uses as its criteria the total mean for both ears at each Specific frequency from each individual institution. HearingiTest: The method used to obtain an individual's auditory threshold, as prOposed by Hughson and Westlake.6 The fundamental feature of this method is that minimum audibility is measured only by progressively increasing the stimulus intensity. In other words, presentations fi— r—r V ‘-v 5Cyril M. Harris, Handbook of Noise Control, New York: MtGraw-Hill Book Company, Inc., (1957), P. 9. 6James Jerger and Raymond Carhart, "Preferred Method for Clinical Determination of Pure-Tone Thresholds,",g;_8. H. D., Vol. 24, (November, 1959) p. 333. 6 always progress from levels where the sound is inaudible to the level at which the stimulus is first perceived. Juvenile Delinquent: As according to Public and Local Acts .. Michigan, 1953:7 Section II. A boy between the ages of 12 and 17 is elig- ible for admission to said boys' vocational school, upon commitment by the juvenile division of the probate court to the state department of social welfare, who: 1. Repeatedly associates with immoral persons, or is leading an immoral life, or is repeatedly found on premises occupied or used for illegal purposes: or 2. Wilfully and repeatedly absents himself from school while being required by law to attend, or repeatedly violates rules and regulations thereof; or 3. Has deserted his home without sufficient cause or is repeatedly disobedient to the reasonable and law- ful commands of his parents, guardian or other custodian; or 4. Has habitually violated municipal ordinances, statutes of the United States defining misdeameanors cognizable by justices of the peace or who has violated any other penal statutes of the state or the United States; or 5. Habitually idles away his time. NontDelinquent: The adolescent who is not incarcerated, but is attending a public high school. fiw— ‘7— v—v —w w v v v-Ir— 7Michigan, Legislature, Publicwand Localfiéctg 1953, No. 122, p. 121-122. CHAPTER II REVIEW OF THE LITERATURE Development of Hearing Tests It was not until 1940 that the co-Operative war efforts of Speech pathologists and otologists brought about the creation of the professional field of audiology.8 The word audiology, itself, did not come into general use until 1945, when Raymond Carhart, a speech pathologist, and Norton Canfield, an otologist, first applied the term to the newly emerging field.9 Since that time, progress in the field of audiology has been momentous. Early techniques such as watch-tick tests, coin- click tests, spoken and whispered—voice tests, and various tuning fork tests, were highly subjective. Advances in testing procedures, however, paralleled the growth of audiology. The early qualitative tests and procedures were soon replaced by techniques which afforded not only qualitative information, but quantitative data as well. One need only observe equipment such as the Bekesy audiomenter, or tests such as the Sensorineural Acuity Level (SAL), Short Increment Sensativity Index (SISI), and the Doerfler~Stewart to detect these —v— 7 fl. I vw—v vn WI 1 1'- 8Hayes A. Newby, Audiology, New York: Appleton-Century Crofts, Inc., (1958), p. 2. 9George E. Shambaugh, Jr., and Raymond Carhart, "Contributions of Audiology To Fenestration Surgery," A.M.A. Archives of Otolsryngology, Vol. 54, (December, 1951), p. 699. 8 advancements. In short, the audiologist no longer asks the question, "Have I a test for this purpose?" Instead he asks, "Which procedure or technique will best serve my needs?" Method of Testing Rapid improvements in testing are readily apparent in Specific areas of audiological concern, as well as in the general field itself. The recognized need for air conduction pure-tone testing, for example, has brought about a multitude of suggested methods and procedures. All of these suggestions, however, in- volve one of three basic methods of stimulus presentation; an ascending sequence, a descending sequence, or a combined ascending-descending sequence. Extensive research has been con- ducted on each of these basic procedures, and each has been advocated by various authorities. In an extensive study conducted by Jerger and Carhart, the ascending technique was compared with both the descending and combined ascending-decending procedures.Io cInneachctest5.a 5 db step was used as the unit of testing and of threshold re- cording. The results of this comparison, from a practical point of view, were indistinguishable.11 The variability among the subjects remained the same from one method to another, and the threshold of a given subject was identical on different measure- ments approximately 65-80% of the time. The results of this study support the contention that a choice among the methods 10James Jerger and Richard Carhart, "Preferred Method For Clinical Determination of Pure-Tone Thresholds." .J.S.H.D.,.Vol. 24, (November 1959), p. 333. 11Ibld. 9 should probably involve a practical consideration rather than a theoretical imperative. Reliability of Testing Procedures Further evidence that variability in testing procedures is minimal is found in a study by Jackson, Fassett, Riley, and Sutton.12 They found that variabilities were small; that the data could be taken at face value, and that the effect of those inter- actions which did exist could be minimized by using better testing conditions. Research conducted by Myers and Harris,13 and by Witting and Hughson14 revealed largely the same results. Still further evidence can be found in a comparative evaluation of auditory measures which was conducted by Jerger, in which he again found relatively little error of measurement.15 Selection of Specifichrocedure In consideration of the results of prior research then, The sources of threshold variability are numerous and are not necessarily related to the variability of the obser- ver's physiological threshold. He will choose a technique for testing which is simple for the subject and which gives an estimate of the observer's physiological threshold 'r r v— 12J. E. Jackson, D. W. Fassett, E. C. Riley, and W. L. Sutton, "Evaluation of the Variability in Audiometric Procedures," The Journal of the Acoustical Society of America, Vol. 34, (February, 1962), p. 220. V 3Jerger, loc. cit. 14Witting and Hughson, "Inherent Accuracy of a Series of Repeated Clinical Audiograms," Laryngoscoge, Vol. 50, (1940), p. 268. 15James Jerger, "Comparative Evaluations of Some Auditory Measures." J.S.H.R. Vol. 5, (March, 1962), p. 16. 10 that satisfies clinical requirements for intra-test relia- bility.16 The Hughson-Westlake technique meets these three criteria. It is highly satisfactory because of the rapidity with which a skilled tester can obtain a threshold and because of the easy task it imposes on the subject. Added merit is the fact that it has been recommended by the Committee on Conservation of Hearing of ' The American Academy of Ophthalomology and Otolarynogology.17 Effects of Ambient Noise To employ a pr0perly calibrated audiometer and a proven technique for testing does not guarantee satisfactory results. The environment in which the testing is conducted must also be con— sidered. An environment which is noisy, or in any way distracting, does not lend itself to reliable results. In general, the relia- bility of results is a function of both the intensity of the noise and the frequency. It is rather self-evident that the louder the ambient noise, the more inaccurate the audiogram will be. Although this problem is some-what alleviated by new sound— deadened testing rooms, the frequency of the sound to be attenuated must still be considered. In a recent study conducted by Eagles and Doerfler, for example, it was found that the low frequencies are the hardest to filter.18 In a school such as the one involved 16Raymond Carhart and James Jerger, "Preferred Method for Clinicaeretermination of Pure-Tone Thresholds." J.S.H.D., Vol. 24, (November, 1959), p. 343. 17Ibld. 18E. L. Eagles and L. G. Doerfler, "Hearing in Children: Accoustic Environment and Audiometer Performance." J.S.H.R., Vol. 4, (June, 1961), p. 161. ' 11 in this study, some of the sounds from a business or typing class, or from a wood and machine shop, would be characterized in part by low frequency components. Effects of Other Extraneous Factors Another extraneous factor to be considered when testing is the physical condition of the subject. A very interesting study was carried out in a Japanese clinic by Saito.19 He studied the effect of various types of strenuous physical activities on hearing thresholds. It was found that exercise apparently produced a temporary shift in some of the subjects.20 According to these results, a clinician must not only consider his equipment, the testing technique and the environment in which the test is con- ducted, but also the physical condition of the patient. The literature concerned with extraneous factors that tend to reduce reliability of hearing threshold measures poses a serious question as to the accuracy of recorded thresholds in general. In a study which was carried out by Eagles and Doerfler, it was found that the thresholds of children are much lower than have been previously reported.21 In view of these findings it may be necessary to make changes, not only in the design and calibra- tion of audiometers, but also in the basic concept of hearing level. 19H. Saito, "Variations in Hearing Acuity in Normal Ears Before and After Physical Exercise." dsh Abstracts, Vol. 1, (October, 1960), p. 19. 2Olbld. 21Eagles, loc. cit. CHAPTER III SUBJECTS, EQUIPMENT, AND TESTING PROCEDURES Subjects The subjects participating in this study were sixty-two juvenile delinquents from the state Boys Training School in Lansing, Michigan and sixty-two boys from a public high school in Holt, Michigan. The total sampled pOpulation was one hundred twenty-four. The boys at each institution were from four age groups. Ages ranged from fourteen through seventeen years. Seventeen subjects were in the fourteen and fifteen year age groups, and fourteen subjects in the sixteen and seventeen year age groups. The boys from the two schools were matched with reSpect to age only. Most of the birth dates were within a few days of one another, and in no instance did the age difference exceed six months. Equipment A portable pure-tone audiometer (Beltone, Model: 10 C) was utilized for obtaining auditory thresholds. Other materials needed for testing were audiograms for recording the thresholds, and red and blue pencils for making the proper symbols on the audiograms. 12 13 Procedure The secretary at Boys Training School assisted in obtaining the subjects for testing. She would call several of the boys to her office, and then send them into the testing room one at a time. As soon as one subject was tested the secretary immediately sent in another. At Holt High School the tester had a more difficult time of scheduling than at Boys Training School, but with the help of the high school office girls the procedure was finally worked out to be a fairly smooth one. The tester would write out "call- slips" for the subjects he wanted and then the office girls would take them to the various rooms. The Specific time for testing was written on the slip, but this did not always prove to be of any value. Mach of the time three or four subjects would arrive at the same time. When this happened the tester had the extra subjects take seats and wait quietly until others were tested. The subjects co-Operated well, so in considering the circumstances the tester thought the procedure ran smoothly. When the tester first met the subjects he engaged in general conversation to establish rapport. The tester also discussed why the subject was needed, and then gave the subject directions for the testing procedure. The boy was told that he should raise his finger or hand every time he heard a sound; a loud tone at 1,000 cycles per second was then presented as a demonstration. He was also told that some of the sounds would be very low in intensity, but that he should reapond even if he just thought he heard a sound. 14 The method of testing employed was the Hughson-Westlake technique. The following steps show the manner in which the hearing tests were administered: 1. The examiner first gave a tone intense enough so the subject could hear it, and so that he knew what he was listening for. Then the tester decreased the intensity in 10 or 15 db steps to where the tone was inaudible. 2. Then the ascending procedure was begun in 5 db steps until the tone was heard. When this level was reached the stimulus was dropped 15 db and another ascent was initiated. 3. The intensity at which the majority of reaponses appeared was considered the threshold; three reaponses at one Specific intensity were criterion for acceptance. 4. Tones were administered as discrete events separated by completely toneless intervals. 5. Each tonal burst was approximately not less than one second and not more than two seconds in duration. The testing was conducted in unused rooms which were provided by the administration of Boys Training School and Holt High School. In both institutions they were classrooms which were not being used during that particular time of the school day. The testing was then initiated and thresholds for 250, 500, 1,000, 2,000, 4,000, and 6,000 cycles per second were obtained. As the threshold for each of these Specific frequencies was found, they were recorded with prOper symbols on an audiogram. Both the right and the left ear of each individual were tested. 15 When the thresholds were obtained the boy was thanked for his participation and then sent back to class. CHAPTER IV RESULTS AND ANALYSES IntrOductign As indicated in Chapter I, a significant difference between the mean auditory thresholds of juvenile delinquents and non- delinquents, might indicate that auditory defects are a potential factor underlying the development of delinquent tendencies. This study was concerned with determining whether or not such a dif- ference exists. The following statistical procedures were there- fore employed to determine the significance of the differences which were found between the mean threshold scores for both the right and left ears of each of the four age groups which were tested. Each of the nine hypotheses listed in Chapter I were tested to determine whether or not they should be rejected. Analyses The first hypothesis was subjected to a statistical analysis which differed from that employed for testing the other eight hypotheses. Here, the mean threshold scores for both the right and left ear were combined into a single composite threshold score for each of the six frequency levels at which the tests were conducted. Rather than determining whether or not these mean composite scores differed significantly, however, a Pearson Product Moment Correlation Coefficient was calculated in the manner shown in Table I. 16 17 TABLE l.--Mean composite threshold scores for both ears of each of the 62 subjects from Holt High School and Boys Training School. Calculations employed in the determination of the Pearson.Product‘ Moment Correlation Coefficient *5 r I mam B.T.S. H.H.S. Product frequency (cps) El E2 E12 £22 i1 552 I 250 8.34 16.81 69.55 282.57 140.19 500 9.22 114.35 85.00 205:92 132.30 1,000 6.36 7.13 40.44 50.83 45.34 2,000 2.89 2.17 8.35 ~24.70 76.27 4,000 4.06 3.50 16:48 12.25 I? 14.21 6,000 10.071 13.18 101.40 173.71 132.72 WWWWW r - .919 Fisher's Z - 1.59 2 ' N -3 1.59 t .09 x 2.58 . 1.36 a 1.82 S.E. .09 ,401 confidence interval therefore equals .88 - .95 18 The formula which was used in this calculation is as follows:22 .. W Y... WWI-X5 -(£X.>") ‘ (N'ixf- (my) The raw scores which were substituted in this formula were the composite mean scores at each of the six frequency levels. This is shown in Table 1. The Pearson Product-Moment Correlation Coefficient was found to be .92. This coefficient was in turn converted into a corres- ponding Fisher's z coefficient of 1.59.23 2.58 arm—~31- were added and subtracted from this number, and the resulting Fisher 2 coefficients (1.36 & 1.82) were then converted back into correla- tion coefficients. The fiduciary probability is .99 that the resulting interval of .88-.95 contains the true r. The procedure is described in Garrett.24 The rationale for computing a correlation coefficient and then determining the confidence interval for this coefficient is as follows: Rather than computing a single mean threshold for the sixty-two subjects from Holt High School and from Boys Training School for all six frequencies, the mean threshold at each frequency was retained. In this manner it was possible to compare the pattern of hearing loss between subjects from the two schools, rather than 22Henry E. Garrett, Statistics in Psychology and Education, Longmans, Green and Co., New York: (July, 1960), p. 143. 23lbld. 2492. cit., p. 199. l9 merely determining whether or not there was a difference between the average loss across the six frequencies. I A confidence interval for the resulting correlation co- efficient was then computed in order to determine whether or not this coefficient was significantly different from zero. Because this interval (.88-.95) did not include a correlation of zero, one may conclude that the correlation between the pattern of hearing loss at Boys Training School and at Holt High School was, in fact, greater than zero. In view of these results Hypothesis number one (There is no relationship between the mean composite auditory thresh- olds for all frequencies of the total sampled population at Boys Training School and Holt High School,) is rejected. A series of E-tests were employed for testing the hypotheses two through nine. The formula which was utilized in this computa- tion is as follows.2 £21....élb. Al IV mum- axm- . (ex P- I I] I 7v" 7,;- x Hpfi- oak N. +N. - 2 chrees or Auden. The results of the tests are listed in Table 2. 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