ENTRODUCIHG PROVESEQNS FOR PERCWALLY MWECAFFED LEARPfiRS TC} PEWR WC W063i CURRECULA Tkasts gar We Degree 0% pk. D. MICmGAN STATE UNWERSITY George Emerson Monroe 1966 We LIBRARY Michigan Stan University This is to certify that the thesis entitled Introducing Provisions For Perceptually Handicapped Learners To Regular Public School Curricula presented by George Emerson Monroe has been accepted towards fulfillment of the requirements for Ph.D. Education degree in “Major professor Date May 201 1966 0-169 ABSTRACT INTRODUCING PROVISIONS FOR PERCEPTUALLY HANDICAPPED LEARNERS TO REGULAR PUBLIC SCHOOL CURRICULA by George Emerson Monroe Statement of the Problem This study identifies and describes new perspectives on the etiology and treatment of learning disabilities. The description included the (l) misunderstanding that held back development in educational programming, (2) growth of special education due to a lack of adequate provisions in regular public school programs, (3) discovery of new evi- dence supporting largely differential development as opposed to damage and injury, (4) importance of early detection of perceptual disorders, and (5) need for indi- vidualized instruction based on results of comprehensive diagnosis. This study was undertaken to (l) establish the sig- nificance of perceptual handicaps relative to slow learners and non-learners, and (2) explore ways in which public school curricula could better provide for the educational needs of these children. The study was historical, descriptive, and analyti- cal in nature. George Emerson Monroe Securing the Data Primary sources of data included government sponsored studies, reports on conferences and seminars sponsored by associations for the help of children with learning disabilities, special publications and unpublished materials produced by individuals, associations, and school systems on programs and research, correspondence and inter- views by the writer with members of the staff at North- western University Medical School, and observations of several public and private school programs for children with learning problems. Secondary sources included various books and articles pertinent to the study. Major Findings of the Study Substantial empirical evidence indicates that: (1) up to 25 per cent of elementary school—age children have some degree of perceptual disorder(s) which interferes with learning as expected in the usual public school situ- ation, (2) the great majority of perceptually handicapped children have near-average, average, or above-average intelligence, (3) most perceptual handicaps are develop- mental in nature and the physical basis of the problem is outgrown in time, (4) unattended or mistreated perceptual disorders very often result in serious emotional problems that persist long after physical maturation has removed the basis of the original disorder, (5) with proper remediation perceptually handicapped children can be taught how to George Emerson Monroe learn effectively in spite of their disability and debil- itating emotional problems can be avoided, (6) very few regular public school curricula have included provisions for perceptually handicapped learners, and (7) lack of provisions in regular public school curricula has led to the establishment of an inordinate number of special or segregated classes in private schools or by departments of special education in public schools. The findings of this study clearly illustrate a need for extensive new public school curriculum development and research focused on perceptual differences and individ— ualized instruction. INTRODUCING PROVISIONS FOR PERCEPTUALLY HANDICAPPED LEARNERS TO REGULAR PUBLIC SCHOOL CURRICULA BY George Emerson Monroe A THESIS Submitted to Michigan State University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY Department of Secondary Education and Curriculum 1966 2,) Copyright by GEORGE EMERSON MONROE 1967 ACKNOWLEDGMENTS As the plan of this study was to gather, coordinate, and interpret evidence developed in both the medical and educational fields, the assistance of many professional persons was essential. It is gratefully acknowledged, how— ever, that special contributions were made by the following persons: Dr. Israel Zivin, neurologist and psychiatrist and member of the faculty at Northwestern University Medical School, provided the information and personal encouragement that led the writer to deve10p the original proposal. He gave professional assistance and arranged for medical resources without which the study could not have been conducted. Dr. George Yacorzynski, Head of the Department of Psychology at Northwestern University Medical School, also played a key role by providing encouragement, medical resource materials, and critical appraisals of the manu- scripts as chapters were drafted. Dr. Troy Stearns, Professor of Education at Michigan State University and the writer's major professor, guided the study from its initial planning to its completion. He provided a highly nurturing combination of understanding, inspiration, encouragement, and scholarly leadership. iii Dr. Loraine Shepard, Professor of Educational Psychology at Michigan State University, served as a member of the guidance committee and was especially helpful in establishing the original guidelines for the study. Dr. Donald Olmsted, Professor and Director of the Social Science Research Bureau at Michigan State Univer— sity, served as a member of the guidance committee and provided constructive appraisals. Dr. Ann Olmsted, Research Associate in Education at Michigan State University, temporarily acted as a member of the guidance committee during the initial development of the study. Her contributions to the basic plans were very helpful. Dr. Charles Blackman, Professor of Education at Michigan State University, served as a member of the guid- ance committee. He also acted as temporary chairman of the committee until the study problem was established. Miss Jean Lukens, Director of the Perceptual Development Program at Oakland County, Michigan, provided many valuable contacts and resource materials and gener— ously shared her own creative insights into the education of perceptually handicapped children. Mrs. Lucille Ingalls, Assistant Professor of Educa— tion at Antioch College, provided creative insights into the processes of individualized instruction. Her classes and the classes of teachers she helped to educate served as models for the writer. iv Mrs. Sadie Monroe, the writer's wife, gave important help as listener, critic, and proofreader. TABLE OF CONTENTS Page ACKNOWLEDGNENTS O O O O 0 O O O 0 O O O O O O O O O 0 iii LIST OF APPENDICESO O 0 O O O O O O O O O O O O O O O Viii Chapter I. II. III. IV. INTRODUCTION TO PERCEPTUAL HANDICAPS IN LEARNING. O O; O O O O O O O O O O O O O 0 O 1 Statement of the Problem Purposes of the Study WORKING DEFINITION OF PERCEPTUAL HANDICAPS. 6 A Foundation Definition A Pathological Beginning Damage and Injury Concepts Contested Difference as Opposed to Defective A Period of Reorganizing and Redefining A Better Working Definition Incidence in the School Population Summary RELATIONSHIP OF PERCEPTUAL HANDICAPS TO 1.0.. 22 Some Professional Conclusions Some Case Study Evidence Test Results Imperfect Measuring Techniques Specific Entities in a Gross Configuration The Case for Variable Development Importance of Early Detection‘ Summary DIAGNOSING PERCEPTUAL HANDICAPS . . . . . . . 44 Behavioral Symptoms to Watch For Recording Observations The Teacher's Limitations in Diagnosis Working with the Parents The Psychometric Examination The Medical Examination Multi—disciplinary Evaluation Summary vi CONTENTS--Continued Chapter Page V. EFFECTIVE LEARNING EXPERIENCES FOR THE POHO CHILD. O I O O O O C O O O O O O O O O 60 The Residential School The Special Day School Segregated Classes The Itinerant Teacher Individualizing Classroom Experiences Special Education vs. Individualized Education Guide for Individualizing Programs Summary VI. RECOMMENDATIONS FOR DEVELOPING NEW CURRICULA. 75 Organizing for Action Taking Inventory of What Exists Defining Problems and Setting Goals Comprehensive Investigation of Previous Research Synthesis of Curriculum Proposals Putting Proposals into Action Evaluating Program Results Needed Educational Research Summary APPENDICES. O O O O O O O 0 O O O O O O O O O O O O O 93 BIBLIOGRAPHY. O O O O O 0 O O O O O O O O O 0 O O O O 11 5 vii LIST OF APPENDICES Appendix I. CHARACTERISTIC BEHAVIORAL SYMPTOMS. . . . . . II. PRELIMINARY "SIGNS AND SYMPTOMS" CATEGORIES . III. STEPS IN ADEQUATE DIAGNOSIS . . . . . . . . . IV. SIX TYPES OF INTRACLASS GROUPING. . . . . . . V. COMMERCIAL SOURCES FOR PERCEPTUAL DEVELOPMENT MATERIALS . . . . . . . . . . . . . . . . . VI. TEACHER DEVELOPED CONCEPTS FOR DEVISING MATERIALS . . . . . . . . . . . . . . . . . VII. ASSOCIATIONS FOR THE HELP OF CHILDREN WITH LEARNING DISABILITIES . . . . . . . . . . . viii Page 93 96 104 105 106 110 111 CHAPTER I INTRODUCTION TO PERCEPTUAL HANDICAPS IN LEARNING Statement of the problem.--Until the opening of the 19th century, it was believed that the smallest division of matter was a molecule. During the next 150 years ever more sophisticated research has disclosed that molecules are really groups of atoms; that atoms are groups of protons, neutrons, and electrons; and that protons, neutrons, and electrons are made up of at least 35 other separate and distinct particles. What was once thought to be indivis- ible was found to be composed of many different things. Concerning the learning needs of children, educators have long been working at a level of understanding that compares to the time when knowledge of the molecule was the extent of understanding of the structure of matter. But today it is recognized that what was once thought to be one kind of child is really an extremely wide variety of different kinds of children. There is now con- crete physical evidence to show that the chances are impos- sibly against any two children ever being exactly alike. As a matter of fact, it is only difference that they abso— lutely have in common. And all of the so—called homoge— neous classifications of learners really represent ranges 1 2 or segments of a continuum, based upon crude and arbitrary standards derived from observations of general symptomatic behaviors. In an article written for American Education Dr. Morvin Wirtz (1965), Director of the Office of Programs for Education of the Disadvantaged and Handicapped, U.S. Office of Education, acknowledged: . . . medical and psychiatric diagnosis have become more exact, so that many children are today recognized as handicapped who yesterday would have been called "behavior problems" [98]. The curricula of most public schools still provide only one limited form of educational experience, highly teacher centered and with common expectations for all, a form that offers maximum learning conditions to very few. The fact that many are able to utilize the curricula to some extent is more of a tribute to the adaptability of children than to the foresight of the schools. Differences in perception and adaptability to limited educational experiences are apparent by the fact that there is always a range of achievement in such learning situations. Far too many teachers even count on a range of responses to occur, taking this to represent effort put forth and making value judgments about the worth of individuals accordingly. It is rarely recognized that much of this variety in achievement is due to the inevitability of varying kinds of responses by varying kinds of learners to a single kind of educational stimulation. And, more often than not, learners who are different enough so that they can't 3 "make-do" with the usual limited offerings are treated as negatively "deviant." Thompson (1964) described the status of ”deviant" learners in public school classrooms: There are two large areas of childhood affliction that are not yet cared for to any sufficient extent by existing schools, services, or agencies. These are disorders of learning and behavior. Many of these difficulties spring from conditions rooted in the cen- tral nervous system or other physiological condition; many can be traced to grossly unfavorable environments; a majority represent some imponderable combination of constitutional misadventure and societal mismanagement [92]. Punishments, ranging from the subtle and psychological to open aggression, are the most widely applied "treatments." It is disturbing to reflect on how much different and bet- ter public education would be today if the ingenuity that has gone into punishing "deviant" learners had been applied to the development of improved programs to deal construc- tively with their natural differences. . . . our procedures in dealing with these youngsters are basically techniques for controlling rather than changing them. . . . The task of developing a program for ”slow learners" depends upon our willingness to study them--to find out who they are as individuals. This requires a complete shift from our usual focus: first, our study must be of the individual as he is-- not as he differs from a norm group (statistical or subjective) which we value; second, we must change our orientation from one of prediction to one of diagnosis in the basic meaning of thorough knowledge. Education has allowed itself to be seduced into the easy life of using information for predictive purposes, which brings with it a tendency to perceive youth in terms of limits of performance. Test scores, grades given by teachers, anecdotal records, and teacher's comments all abound in references to what is to be expected in the future as if the future must be basically a reproduction of the past. Diagnosis, on the one hand, is concerned with the present and, as it looks to the future, it looks with the attitude of how the future can be different 4 from the past, what interventions can be made that will bring about changes in John and Jane [67]. Purposes of the study.-—The purposes of this study are to: (1) call attention to a group of learners, with average or above intelligence, whose perceptual apparatus differences (physically and organizationally) are suffi— cient to escape detection by all but the most sophisti— cated diagnostic techniques but prevent them from working as expected with the limited educational experiences usually offered in the public schools; (2) establish evi- dence of the correlation between these "perceptual handi- caps" and I.Q.; (3) suggest means for identification and adequate diagnosis of students who may have perceptual handicaps; (4) propose some curriculum provisions needed in the public schools to deal effectively with perceptually handicapped learners; and (5) discuss ways that a profes- sional staff can learn about perceptual handicaps and how to deal with them effectively. Much of the literature dealing with perceptual handicaps is very recent and in the form of special publi- cations by the researchers themselves. Some is in the form of conference and seminar reports. Some is in the form of papers duplicated by school systems for staff use. In defining the nature of perceptual handicaps this study will point out some very recent and very important changes in the basic philosophy regarding the perceptually handicapped child. And, as this story unfolds, it will be documented 5 by pertinent quotes from, and references to, the literature in the field. In order to establish the significance of perceptual handicaps in the problems of slow learners and the correlation between 1.0. and perceptual handicaps, the study will rely almost exclusively upon material from research and conference reports, case studies, and school records. In other words, this study will be built upon data produced by a wide variety of responsible persons and agencies. It is largely an effort to search out and coor- dinate evidence not generally available or previously brought together in this manner. Since the literature will necessarily be reviewed extensively throughout most of the study, no special or separate chapter will be devoted to a review of the literature. It is further intended that this work might serve teachers as a handbook-type reference for learning about the nature of perceptual handicaps and how to deal with them effectively. CHAPTER II A WORKING DEFINITION OF PERCEPTUAL HANDICAPS A foundation definition.--At this point in time there is a great variety of definitions of perceptual hand- icaps and related terms to choose from. Most of these grew out of the findings of individuals and groups working on the problem without much knowledge of what others were doing and finding. And, as such, they reflect the particu- lar interests and specialized backgrounds of the persons who originated them. Researchers in the area of perceptual handicaps have represented many professions from education to neurology and psychiatry, but most of the fundamental information has been produced by persons working within or closely related to the medical schools. Perception may be considered as the process of becoming aware of the environment through stimulation of the sensory apparatus and developing a coordinated view of that environment so that one can cope with it and make sense out of it. And it is now believed that the sense made out of the messages received by the brain from one's environment is different for each individual. The cele- brated pioneer in the study of perceptual processes, Adelbert Ames, Jr., conducted thousands of experiments at 6 7 the Dartmouth and Hanover Institutes. In an exchange of letters with John Dewey (1949), he wrote of his conclusions regarding the individuality of perception: Among other things that these demonstrations apparently disclosed was that in essence every individual's per- ception was different than every other individual's perception, i.e., perception is specifically individ- ually unique due to that person's unique point of view both in space and from his position in his unique history with his unique purposes, etc. [18]. For the purposes of this study, then, it should be under— stood that the perceptually handicapped learner is one of good intelligence whose perceptual processes are different enough so that he has difficulty in coping with and making "acceptable” sense out of the uSual stimuli received from the usual educational environment. A pathological beginning.--It is unfortunate that the limited evidence available to those who first began to offer definitions and establish terms relative to percep- tual handicaps caused them to believe that all such prob- lems were manifestations of brain injury. Most notable among these pioneers was Alfred A. Strauss. Dr. Strauss believed that many of the learning difficulties evidenced by children were of organic nature. He also felt that while these problems were physical in nature and presented obstacles to learning under ordinary circumstances, they did not rule out the possibility of worthy achievement under specially constructed circumstances. But, on the basis of a series of studies of children known to have 8 brain injuries, he concluded that any child who exhibited the same characteristic patterns of behavior and psycho— metric performance could be presumed to be brain injured. When Strauss wrote of his view with Lehtinen (1947), and Kephart (1955), this theme was so convincingly presented that it has since dominated the thinking of most persons who have worked with perceptual handicaps. The two volumes produced by these authors became the basic hand- books for identifying and working with perceptually handi- capped children [88,87]. Damage and injury concepts contested.--Though the books written by Strauss and associates are still among the best basic resources in the field, their brain-damage point of view has been questioned in recent times. Strother (1963), writing in a monograph produced for the National Society of Crippled Children and Adults, Inc., criticized: A presumption of brain injury based on such historical, clinical, psychometric or behavioral evidence may or may not be valid. Strauss' argument on this issue has been criticised in detail by Sarason (1949). In a large number of cases there is, at the present time, no way of determining conclusively whether children show- ing these so—called "si ns" of brain injury are actually brain injured 89]. At the annual conference of the National Society for Crippled Children and Adults, held in Chicago, Lehtinen (1963) presented a description of the perceptually handi- capped child that still included the concept of brain damage but gave recognition to other possibilities: 9 Present day diagnostic techniques and clinical insights in the specialties of psychology, pediatric neurology, and encephalogy make it possible to identify the exist- ence of a disturbed condition in the central nervous system which is adversely affecting the child's learn- ing and adaptive behavior. Chief among the various causal explanations which have been proposed are that the central nervous system malfunction is the result of reproductive or neonatal casualty . . . that it is the reflection of a maturational lag . . . or that specific learning deficits are the result of genetic constitu- tional factors . . . [62]. Kephart (June, 1963) delivered an address at the First Annual Conference on Children with Minimal Brain Impairment, held at the University of Illinois, in which he, too, spoke of the perceptually handicapped with a little less emphasis on the concept of brain damage, using the word "minimal" in his only reference to it: In dealing with minimal brain injured children, it is frequently observed . . . [53]. And, in a recently published article on the subject (December, 1964), he wrote almost exclusively of learning disabilities, giving only the slightest attention to the pathological concept of damage when he stated: . . . in a significant percentage of children, acci- dents occur during the developmental period [52]. No one questions the fact that there are some children, an important number of them, who have some degree of brain injury. And it has been clinically demonstrated by studies of children known to have brain injuries that these can give rise to a variety of perceptual problems in learning. But more and more the accumulating evidence indicates that the category has been used too broadly. 10 Even if a fairly large sample of children who are known to have brain injuries exhibit behaviors symptomatic of per- ceptual problems in learning, this is not grounds for deducing that all children exhibiting behaviors symptomatic of perceptual problems in learning have brain injuries. Thompson (1964) expressed it this way: The term "brain injury" probably should be eliminated from general use. It is a medical term that is justi-‘ fied only after positive medical evidence. Frequently, the term is used loosely to refer to any condition of integrative disturbance in the central nervous system, or even more loosely to conditions of assumed organic involvement. The same objections apply to the term "brain damage." These terms may be used only in pre- cise medical reference [92]. Difference as opposed to defective.--It appears that a child with perceptual problems who is labeled as "brain injured" or "brain damaged" may often be more handicapped by the label than by his learning problems. The probabili- ties are very high, also, that such a diagnosis is made on evidence far too inadequate to be considered valid. Still, the learning problems do exist. And there is strong evi— dence that a great many of them have some kind of physical (rather than emotional) origin. For instance, according to Clements (1963): Past and recent studies have indicated that as many as 70 per cent of the youngsters referred to child guid- ance clinics for whatever reason, can be shown to have mild neurologic differences which form the basic eti- ology of their difficulties. This leaves a relatively small percentage whose problem behavior can be explained on a purely psychogenic basis [22]. 11 Notice that Clements used the concept of "difference" as opposed to those terms which, in essence, say "defective." It further seems that by this time he had found cause to visualize perceptual differences as at least three different kinds of differences when he referred to them as either: . . . mild organic impairment, or mild brain injury, or minimal brain dysfunction [22]. A period of reorganizing and redefining.--Myklebust (June, 1963), speaking at the First Annual Conference on Children with Minimal Brain Impairment, also took a step toward a less pathological view by acknowledging: The etiology might be disease and accidents, or it might be developmental [71]. And he proposed that the term psychoneurological learning disorders be used to designate the area of study that con- cerns itself with the behavioral disorders associated with brain dysfunctions in human beings. In a later article (December, 1964), he clearly took a stand against the damage point of view when he stated: Most~workers have found the term brain damage inade- quate. Some feel that it is unusualIy diSEressing to families and others recognize it in many instances as being inaccurate and hence a misnomer. Dysfunctions in the brain that cause learning disorders are not necessarily due to damage. They might be developmental or they might occur on an endogenous basis and be hereditary in nature [70]. In very recent times several other authors have begun to make some mention of the possibility that percep- tual handicaps can be rooted in a different (but not 12 faulty) rate of physical and organizational development. Crowther (1963) claimed: . . . many of these problems are transitory. Why they should be transitory we don't know. It is as though these children were not damaged in the normal sense of damage, but have what I term cerebral dysmaturation [25]. Wepman (1963), also, delivered an address at the First Annual Conference on Children with Minimal Brain Impairment in which he proposed that more research be directed toward finding ways to distinguish between damage problems and developmental problems. But a summary of the discussion following his address indicates that his proposals were generally regarded as premature [96]. However, Frostig and Horne (1964) published a Teacher's Guide to the Frostig Program for the Development of Visual Perception in which full recognition was given to the developmental concept when they stated: It is often extremely difficult to discover the factors contributing to a child's disabilities in visual per- ception. The cause may be pathological—in origin, such as minimal brain dysfunction, or it may be simply a lag in perceptual development without readily discernible causes [32]. A better working definition.-—In 1964 Dr. Sam Clements became Project Director for a three-phase Project on Minimal Brain Dysfunction in Children. This project was co-sponsored by the National Institute for Neurological Disorders and Blindness and the National Society for Crippled Children and Adults, Inc. A report (1965) on Phase I of this project, edited by Dr. Clements, summarized: 13 A semantogenic struggle has developed over the use of the term "brain damage" as either a diagnostic or des- criptive designation. Historically, the terms "brain— crippled," "brain-injured," "brain-injured child," were selected by Strauss, Werner, Lehtinen, and others to describe and account for particular learning and behav- ioral aberrations in certain children. Other writers, in contributing to or expanding the concept and/or in describing the condition(s) used such transitional terms as "brain damage," "brain-damaged child," "brain dysfunction," "cerebral dysfunction," etc. With fre- quency of appearance in the literature serving as an index, the appellatives "brain damage," and "brain- damaged child," seem to be the most popular, insofar as usage is concerned. Although these two terms are the most widely employed, most writers agree that they are unfortunate in that they connote specific demonstrable brain alterations, are unclear, erroneous, too inclu- sive, and/or represent a "limited" Straussian view. . . . Despite criticism of these terms, it would appear that the authors using "minimal brain damage," or "minimal brain dysfunctions," have done so in an honest effort to characterize categories of children who are different in certain learning and behavioral patterns, bit who on individually administered, comprehensive intellectual assessment, though indeed heterogeneous, nevertheless, achieve within the near normal, normal or above normal ranges of intellectual functioning . . . [20]. Dr. Clements and the project staff made a review of selected literature within which a total of 38 different terms were used to describe or distinguish the conditions of perceptual handicaps. These were placed into two groups: those which stress the organic aspect of the con- dition and those which emphasize a particular segment or consequence of the condition: GROUP I Association Deficit Pathology Organic Brain Disease Organic Brain Damage Organic Brain Dysfunction Minimal Brain Dysfunctions Minimal Brain Damage Diffuse Brain Damage l4 Neurophrenia Organic Driveness Cerebral Dysfunction Organic Behavior Disorder Choreiform Syndrome Minor Brain Damage Minimal Brain Injury Minimal Cerebral Injury Minimal Chronic Brain Syndromes Minimal Cerebral Damage Minimal Cerebral Palsy Cerebral Dysynchronization Syndrome GROUP II Hyperkinetic Behavior Syndrome Character Impulse Disorder Hyperkinetic Impulse Disorder Aggressive Behavior Disorder Psychoneurological Learning Disorders Hyperkinetic Syndrome Dyslexia Hyperexcitability Syndrome Perceptual Cripple Primary Reading Retardation Specific Reading Disability Clumsy Child Syndrome Hypokinetic Syndrome Perceptually Handicapped Aphasoid Syndrome Learning Disabilities Conceptually Handicapped Attention Disorders Interjacent Child With few exceptions, the most striking omission throughout the review of the literature was the lack of attempts at a definition of the term(s) used or the condition discussed. Whereas there is a more than ample supply of terminology and characteristics, there is a shortage of interpretative elucidation [20]. The task of developing a more suitable definition that would incorporate recent evidence and be (at least tenta- tively) more universally acceptable as a generally descrip- tive classification became one of the main goals of the project. After much deliberation by the twelve members of the Task Force One Committee, such a definition was agreed 15 upon. It was called the Minimal Brain Dysfunction Syndrome and reads as follows: The diagnostic and descriptive categories included in the term minimal brain dysfunction syndrome refer to children of near average, average, or above average general intelligence with learning and/or certain behavioral abnormalities ranging from mild to severe, which are associated with subtle deviant function of the central nervous system. These may be characterized by various combinations of deficit in perception, con- ceptualization, language, memory, and control of atten— tion, impulse, or motor function. Similar symptoms may or may not complicate the problems of children with cerebral palsy, epilepsy, mental retardation, blindness, or deafness. These aberrations may arise from genetic variations, bio-chemical irregularities, perinatal brain insults, illnesses or injuries sustained during the years criti- cal for the development and maturation of the central nervous system or from unknown causes. The definition also allows for the possibility that early severe sensory deprivation could result in cen- tral nervous system alterations which may be permanent. During the school years, a variety of special learn- ing disabilities is the most prominent manifestation of the condition which can be designated by this term. The group of symptoms included under the term mini- mal brain dysfunction stems from disorders which may manifest themselves in severe form as a variety of well recognized conditions. The child with minimal brain . dysfunction may exhibit these minor symptoms in varying degree and in varying combinations [20]. The Task Force One Committee, while able to agree upon the foregoing definition, nevertheless realized that it must be tentative. It is offered as a working defini— tion, subject to revision in the light of new evidence and/or new perspectives on present evidence. It can help to facilitate better communications on perceptual problems, even though it should not be used as more than a good organization of incomplete information. by the committee. 16 But, it is puzzling to observe the next step taken It seems that they have drawn conclu- sions far beyond the available supporting evidence, in much the same manner as when Strauss concluded that all children who exhibited certain characteristic behaviors and psycho- metric performance could be presumed to be brain igjured. In the Classification Guide which the committee prepared to accompany and illustrate the definition of Brain Dysfunc- tion Syndrome, they have designed what appear to be contin- uums of symptomatic behaviors: 5. Classification Guide BRAIN DYSFUNCTION Minimal (Minor; MIld) Impairment of fine movement or coordination. Fluctuations in learning and retention, especially in specific intellectual capabilities such as mem- ory, language skills, etc., as related to sub— clinical seizures. Specific and circum- scribed perceptual and intellectual deficits. Deviations in attention, activity level, and impulse control. Impairments of vision or hearing. SYNDROMES Ma or ( evere) Cerebral Palsies. Epilepsies. Mental Subnormalities. Autism and other gross disorders of behavior. 5. Blindness and deafness [20]. This design seems to leave little room for anything other than a pathological explanation for perceptual problems, in l7 spite of earlier acknowledgments that there might be other causes. There is little or no recognition in the Classifi- cation Guide of the possibility of slower than expected, but not necessarily defective, physical and organizational development. Yacorzynski (1965) cautioned about the gross assignment of perceptual problems to organic causes when he wrote: And The term "organicity" is reserved for those clinical observations which lead to the conclusion that they are due to an organic condition of the brain involving higher mental processes. Sometimes the term is used to indicate that the symptoms are such as to make the individual act as if he had an organic involvement without an actual impairment being present. Such a broad meaning of the term loses its value because it may include any behavioral manifestation simulating that of an organic patient. In neurosis or a psycho- sis, many behavioral characteristics and performance on organic tests resemble those of a patient with an organic involvement of the brain. Such patients cannot be placed in the category of the organic unless data are available from other sources and previous observa- tions indicating that such indeed is the case. It is best to reserve the term "organicity" for patients in whom organic involvement of the brain is indicated to be present [100]. he further claimed: Organicity may be permanent or temporary [100]. If these differences of opinion among the profes- sional researchers and theorists sometimes seem difficult for the educator to work with, it should be remembered that such is inevitable in any field where real growth is taking place. And, if one adopts an attitude of continuing inves- tigation which includes caution toward the indiscriminate use of "labels," much positive use can be made of what there is to work with, however incomplete. 18 Incidence in the school population.--In this study the perceptually handicapped learner has been defined as one of good intelligence whose perceptual processes are different enough so that he has difficulty in coping with and making sense out of the usual stimuli received from the usual educational environment. Evidence has been offered that perceptually handicapped students can learn to learn effectively, very often to the point of meeting the usual expectations in regular classroom situations. As diagnos- tic techniques become more systematic and precise, it is seen that the incidence of perceptual handicaps is much greater than previously suspected. Professional estimates range from a minimum of 5 per cent to a maximum of 25 per cent of the total elementary school population. On the basis of findings from surveys Myklebust (1964) reported: . . . it seems that a minimum of 5 percent of school children have learning disorders as a result of distur- bances of the brain; some authorities place the inci- dence even higher [71]. Bateman (1964) felt she was conservative in estimating: . . . that perhaps five percent to ten percent of the school population has severe enough reading problems to require special educational concern and provisions [7]. While President of the New York Association for Children with Learning Disabilities, Harrison (1965) wrote: Many of the advisors of our new international organi- zation, Association for Children with Learning Dis— abilities, Inc., have stated that a minimum of 5% to 15% have some form of neurological damage that creates the problems in perception and behavior [38]. 19 A considerably larger estimate was made by Frostig and Horne (1964): Our studies in various school systems show that approx- imately 20 to 25 per cent of children starting first grade lack the necessary perceptual maturity to succeed in beginning reading, arithmetic and writing without putting forth undue effort. Estimates of the number of school children in the United States who have reading difficulties beyond this point vary between 10 and 25 per cent, a considerable proportion of whom can be assumed to have continuing visual perceptual problems [32]. No comprehensive studies have yet been conducted to determine the actual incidence of perceptual handicaps among children of elementary school age. The estimates found in the literature are based upon personal experience and case record analyses. Myklebust has recently (1966) obtained a large grant to study the incidence of brain- injured children in the general population. No doubt the incidence of the various types of perceptual handicaps can be better estimated when data from this study are known. There is no question, however, that the incidence is highly significant. Summary.--Perception may be thought of as the process of becoming aware of the environment through stimu- lation of the sensory apparatus and developing a coordi- nated view of that environment so that one can c0pe with it and make sense out of it. And the sense made out of the messages received by the brain from one's environment appears to be different for each individual. The percep- tually handicapped learner has been defined as an individual 20 of good intelligence whose perceptual processes are different enough, whatever the reason, so that he cannot perform as expected with the usual forms of public school experience. Historically, the first persons to recognize that these were children who couldn't (rather than wouldn't) perform as expected presumed that they were all "brain injured," or "brain damaged." As diagnostic tech- niques improved and case study records were carefully kept and analyzed, it became apparent that the pathological con- cepts of "damage" and "injury" were not only unfortunate in connotation but without sufficient medical evidence to warrant their general use. Many researchers, working in relative isolation and without much knowledge of what others were doing and finding, developed definitions and terms to describe perceptual problems and their causes. As a result, the field became confusingly saturated with spe- cialized terms, none of which seemed comprehensive enough for the job as more and more types and kinds of perceptual problems were discovered. What was once thought to be one kind or type of learning handicap has turned out to be a whole range of different kinds and types. And as diagnos- tic techniques improve, who knows how many other kinds and types will show up. Perhaps there will ultimately be as many as there are children. But this much seems certain even now: some of these problems may be due to injury, some may be due to genetic variations, some may be due to temporarily arrested development, and some may be due to 21 slower than expected rates of healthy physical and organi- zational development of the central nervous system. What- ever the causes, a significant number of children with good general intelligence have perceptual handicaps and need tailor-made experiences in order to be taught how to learn effectively. Considerable case study evidence is already available to support the conclusion that a child may have a perceptual handicap and yet have average or above-average intelligence, and that if his special needs are provided for he can learn to learn effectively, very often to the point of eventually holding his own in the regular class- room situation with its usual program.- Perceptual problems affect a significant portion of the elementary school popu— lation, a minimum of 5 per cent and possibly as much as 25 per cent. As these children have average or above-average intelligence and can be taught to learn effectively, the present loss of competent manpower is serious for society and unnecessarily destructive for individuals. CHAPTER III RELATIONSHIP OF PERCEPTUAL HANDICAPS TO I.Q. Some professional conclusions.--It is useful to compare a spectrum of professional opinions developed by those whose everyday practice and/or research activities keep them on the "firing line." These people are subject to the ethical norms of professional integrity and probing questions from colleagues. They generally strive to keep their pronouncements based on sound and substantial evi- dence lest they be discounted or taken lightly in the professional marketplace. This does not mean that they will always be right or that they have mastered the comm prehensive view. But they are generally able to make positive contributions to understanding, especially when their views are utilized with an attitude of relativism and continuing investigation. As early as 1947 considerable first-hand classroom experience, research activity, and broad acquaintance with the findings of others in the field prompted-Strauss and Lehtinen to write: Behavior and learning, it is now beginning to be recog— nized, may be affected by minimal brain injuries with- out apparent lowering of intelligence level [88]. 22 23 As was stated in Chapter II, these authors, along with Kephart, were pacesetters in the field. A great deal of useful work has been inspired by their insights. While accumulating evidence has now caused their concept of "brain damage" to be rejected by most professionals, their conclusions regarding the correlation between perceptual handicaps and 1.0. have been steadily gaining in credi- 'bility as new evidence is made available. In a discussion of the correlation between percep- tual handicaps and 1.0., based on her extensive experience with psychological testing, Spraings (1963) wrote: This is a group that varies widely. These children are to be found at all intelligence levels, from the mentally retarded to the gifted . . . [86]. That same year, in another situation, Crowther (1963) exam- ined the evidence at his disposal and proposed a slightly different conclusion: These children . . . may have superior intelligence. . . . In theory, a child could be an Einstein mathe- matically and yet not read. And if you have not seen them, it may surprise some of you to know that there are many children who have a high overall intelligence, (as expressed on psychometric examination) et who can- not read. Children who could go through [a university with honors, yet can't read [25]. The Department of Special Education, Oakland County, Michigan (1961), made a most comprehensive study of the evidence concerning perceptual problems in learning. They made a survey of the literature and visited with Strauss, Lehtinen, Kephart, and several others. Subsequently, they established a Perceptual Development Program for the 24 Oakland County Schools with the following eligibility criteria: . . . children to be considered eligible for the pro— gram should . . . . Be of potentially normal intelli- gence or above [74]. And two years later, in a paper prepared for and published by the Fund for Perceptually Handicapped Children, Inc., Evanston, Illinois, Lehtinen (1963) had apparently firmed up her own convictions concerning perceptual handicaps and 1.0. when she described: . . . the child with perceptual handicaps in learning . . . overall intelli ence quotient indicates ability within normal limits 64]. In very recent times the belief that most percep- tually handicapped children have good basic intelligence has gained increasing acceptance. The published statements of Bryant [15], Shankweiler [85], Russell [83], and Myklebust [70] serve to illustrate this interpretation of the evidence. Bryant (1964) referred specifically to the perceptually handicapped children that have extreme diffi- culty in learning to recognize words. Such a condition of "word blindness" is commonly referred to as dyslexia, a term which: . . . implies a neurological dysfunctioning if only because of its similarity to the neurological condition alexia, which represents the loss of ability to read resulting from damage. . . . However, while alexia is a traumatic disruption of existing skills and memories, dyslexia represents a developmental inefficiency in functioning that handicaps learning. . . . Dyslexia is not a broad defect in general intelligence; I.Q.‘s tend to be in the normal range and occasionally reflect very superior ability [15]. 25 Shankweiler (1964) conducted a detailed study of twelve pupils with dyslexia. These children were given a clinical neuro-psychiatric examination and test for perception and skill. Their dyslexia was found to be associated with directional difficulties and trouble with drawing. In half of the cases, the confusion was with letters, and visual not acoustic in nature. On the basis of EEG examinations, it was assumed that half of the group had minimal brain damage. But none were considered below normal in intelli- gence [85]. Russell (1964) advanced a somewhat more com- prehensive conclusion concerning I.Q. (interwoven with a hypothesis about curriculum) in which he stated: First and foremost, we feel that these children who appear to be completely incapable of achieving academi- cally can learn in a highly satisfactory manner accord- ing to usual school standards in an environment that is highly structured, organized, and with the use of special materials and methods [83]. Myklebust (1964) made a very serious attempt to coordinate a wide spectrum of accumulating evidence, based on his own extensive research at Northwestern University and wide acquaintance with the work of other specialists in the field. He described the relationship of 1.0. to perceptual handicaps as follows: In fact, until recent years children presenting prob- lems in learning and adjustment were categorized prin- cipally as being mentally retarded, sensorially impaired, or emotionally disturbed. Then workers became aware that there were children who though unable to learn to comprehend, speak, read, write, tell time, play, calculate, distinguish between right and left, and relate well to others, showed no basic deficiencies in intelligence, had no sensory impairments, and were not primarily emotionally disturbed. It was through a 26 need to find a new, more appropriate, and meaningful classification for these children that the concept of minimal brain damage developed. . . . In the population with minimal brain damage, it is the fact of adequate motor, average to high intelligence, adequate hearing and vision, and adequate emotional adjustment together with a specific disability to learn that constitutes the basis for homogeneity [70]. The California Association for Neurologically Handi- capped Children recently published a monograph (1965) in which the relationship of 1.0. to perceptual handicaps is discussed. Their experiences with many such children and the various experts and agencies that have worked with them led the editors to state the position of the association as follows: His appearance is normal, his intelligence is average or better, he receives love and attention; yet he is a menace to his neighbors, a disruptive influence in the regular classroom, an unsolved puzzle to his parents. He cannot perform. . . . He actually sees and hears things differently . . . [91]. Perhaps the most comprehensive "pulse feeling" by recog- nized experts in the field is represented in the report by Clements and associates (1966) on Phase I of the Project on Minimal Brain Dysfunction in Children, co-sponsored by the National Institute for Neurological Disorders: Despite criticism of these terms, it would appear that the authors'using "minimal brain damage," or "minimal brain dysfunctions," have done so in an honest effort to characterize categories of children who are differ- ent in certain learning and behavioral patterns,-But who on individually administered, comprehensive intel- lectual assessment, though indeed heterogeneous, never- theless, achieve within the near normal, normal, or above normal ranges of intellectual functioning [20]. 27 Some case study evidence.--Case study reports, alone, are cumbersome devices if the interest is in estab— lishing trends and probabilities from which to derive basic principles. Used in conjunction with other types of evi- dence, they can help to illustrate the meaning of inanimate numbers. And they can assist greatly in the formation of perspectives. The case studies presented here speak of the corre- lation between 1.0. and perceptual handicaps, but they will also give some insight as to what classroom behaviors are characteristic of the youngsters involved. The first case study began in August, 1949. Jimmy had been unable to pass grade eight after two attempts, and he was referred for more comprehensive diagnostic testing. He was examined by a psychologist, a psychiatrist, and an eye specialist. They could find no reason for his failure. The psychologist pointed out that he had sufficient intel- ligence for university work but was unable to mobilize himself for academic work. He recommended that in view of this problem Jimmy should study farming or animal hus- bandry. This was a severe blow to his parents. They had always expected to send their only son to a university. As his father was a statistician and his mother a former school teacher, Jimmy's home had always been rich in cultural and intellectual stimulation. It was the kind of environment that generally fostered high scholarship. In 28 September Jimmy was re-enrolled in the same school and commenced visual-perceptual training. His parents soon noticed an improvement in concentration and reading ability. When the training was completed, four months later, Jimmy's teacher reported that he was keeping up with the class and making satisfactory grades in all subjects. After graduating from high school in 1953, he was accepted in a university [58]. Tommy Miller's problems illustrate another type of perceptual handicap. Even his mother felt that he was a spoiled brat. At seven years of age his behavior was such a constant source of irritation that it drove his normally calm mother to the point of a nervous breakdown. Evening meals were invariably the scene of screaming, kicking, tantrums before dessert was served. And the situation at school was little better. In kindergarten, Tommy was unable to do the things that other children were doing. He couldn't color within the lines of a figure or work with cut-outs. In first grade it was discovered that he had a normal reading ability, but he couldn't print letters or numbers properly. When moved into second grade, his prob- lems increased. He seemed to have no conception of shapes like rectangles or squares. Because he couldn't fold a spelling sheet in half, as the teacher ordered, he tore it into bits and handed in the scraps. At first, it was thought that there was something psychiatrically wrong with Tommy, but nothing satisfactory came from several attempts 29 to diagnose his problem from this point of view. His brain-injury diagnosis was made in 1955, about the time that a pilot class for brain-injured children was initiated at P.S. 85 in the Bronx. He was one of the six "lucky" students to be placed in the class. After three years in this special situation, Tommy returned to normal classes and has received regular promotions ever since. In junior high school he played a saxophone in the band and took part in other extracurricular activities. He has made remark— able adjustments in spite of his handicap [6OJo Still another case which illustrates the extreme variability of basic causes that may underlie perceptual handicaps was cited by Kirk (1963) when he described: . . . a child who was not manageable in a classroom because of extreme hyper-activity. He tested border- line in intelligence, could not learn to read, had short attention span and demonstrated other behavior characteristics ascribed to brain-injured children. No neurological signs were found to confirm the diagnosis of cerebral dysfunction. At the age of ten, he was found to have hypoglycemia, a condition opposite to diabetes, in which the sugar was being burned up too fast. When this diagnosis was made and sugar added to his diet, he became a model boy and learned in school at a rapid rate [57]. Different as these cases are, they do not begin to exhaust the possibilities. There is something unique about each individual case, even though some general symptomatic behaviors (such as hyperactivity) may be similar. There- fore, in order to have integrity, any remedial program must necessarily involve thorough diagnosis to pinpoint each individual's unique perceptual handicap. 30 Test results.—-Grover and Allen (1962), writing of the results of screening procedures used in a Demonstration Project for Brain-Damaged Children in Ohio, had this to report on the correlation between perceptual handicaps and I.Q.: In the Columbus Public School System, a series of classes now numbering five, has been conducted for the past four years for children who are hyperactive, who have a short attention span and who exhibit consider— able emotional lability. In the school year 1960-61, the children in these special classes were studied medically. All in all, sixty-one children were included in this study. Forty-eight of these sixty—one started in the research program and thirty-four con- tinued in the program to its completion. In another, but concurrent study of private patients, fifty-eight more were seen in consultation, making a total of one hundred nineteen who were evaluated. Of this, a total of nine, and all of these were in the private group, were found to have primary problems of a psychiatric nature while the problems of the other one hundred ten were felt to be the reflection of some organic damage to the brain. In the school group, the ages ranged from six to fourteen. In the private study, the ages ranged from three and one-half to sixteen years. Of the school group, the I.Q.'s ranged from 80 to 129. In the private group, they ranged from 60 to 132 [37]. Lukens (1966), Coordinator of the Perceptual Develop» ment Program at Oakland County, Michigan, has reported on a study of the first 400 cases in the program files. These files were of children with severe learning problems who were referred for comprehensive diagnosis and possible placement in special rehabilitation classes. Each child was tested with a variety of instruments, including the WISC and Bender-Gestalt. Over 60 per cent of these children were judged by the screening committee to have potential for normal intelligence and specific disabilities 31 in perception. It was also the opinion of the committee that even those with lower scores were more intelligent than their general or average scores indicated and that 1.0. tests generally underestimated the real potential of children with perceptual problems [66]. Imperfect measuring techniques.--I.Q. tests have for some time been subject to mounting criticism by profes- sional educators, psychologists, psychiatrists, and others. The criticism has not been so much against the concept of 1.0. testing. This is still regarded by most as a useful procedure. The clamor has been against assuming too much for what such testing can accurately determine. It is now known that 1.0. tests measure what the experts call "learned responses," not intelligence [90]. And it is a matter of record that under specially constructed circum- stances the I.Q. score for a given person can be raised. For instance: After four years of doing without schooling, Negro junior high students in Virginia's Prince Edward County returned to class in September 1963. In the course of the next 18 months, the average 1.0. of those children rose 18 points. In St. Louis, a cultural enrichment program in slum schools raised the pupils' average 1.0. by 11.5 points in 4 years. . . . Testing, as a measure- ment of progress and aptitude, will always have its uses, but the old myth about the omnipotent 1.0. is finally fading [90]. Kessler (1965) also discounted the myth of 1.0. constancy: As measuring tools, 1.0. tests have much less relia- bility than tools of physical measurements. The proba— bilities of 1.0. changes over a period of time have been well researched. . . . One study showed that in a 'group of children first tested at six years and 32 retested at twelve years, 50 per cent showed I.Q. changes of 8 points or more, with 25 per cent changing 13 points or more. The accumulation of such figures has completely destroyed the myth of 1.0. constancy. The changes are in part errors of measurement, and in part changes in the individual being tested [55]. Perhaps the most serious I.Q. evaluation errors have been made with the slow learners and non-learners in the school population. There is now reason to believe that many children in the public schools have been grossly mis- understood and mistreated on the basis of indiscriminate testing procedures. Spraings (1963) put it this way: First of all, the 1.0. obtained often does not describe with accuracy the specific problems causing the impair- ment in performance. . . . Secondly, often we see wide variability in verbal and performance areas, and thirdly, more important than the 1.0. obtained will be the areas of strengths and deficits revealed in the intratest variability . . . [86]. Strother (1963) criticized: On such tests as the Stanford-Binet, which yields a single 1.0. score based on the average level of per- formance on various kinds of tasks, the averaging of relatively good and relatively poor performances results in a score that provides very little useful information [89]. And Lampert (1965) made this startling comment: The diagnosis of mental retardation in non- institutionalized children is incorrect in 85 to 90 per cent of cases. . . . Most of these children have devel- opmental disorders of learning and language function "which commonly occur without any impairment of intel- ligence." . . . Among learning and language disorders, Dr. Lampert included problems in reading that prevent word recognition and the comprehension of word meaning in printed, written, or spoken speech, and in expression. "The greatest single cause of misdiagnosis of mental retardation is failure to separate intelligence from language, speech, sensory, motor, and spatial modali- ties with respect to testing," he maintained. . . . The standard intelligence tests are "notoriously misleading" 33 in the language disordered individual, he continued, in part because of associated problems in behavior, Spatial relationships, and motor function. A typical behavior pattern in these children is characterized by hyperactivity, impulsivity, and distractibility, he said. a o a He offered . . . examples of the specificity of learning problems in the language-disordered child, related to specifically affected areas of brain func- tion. For instance, the language disordered child may be able to read words, said Dr. Lampert, but not to comprehend what he reads or to hold a sequence of meaning. Or he may have a visual stimulus of a word but be unable to sound it out [27]. Specific entities in a gross configuration.--The I.Q. score is a gross configuration. It represents an averaging of performance scores on several different sub- tests. Even these sub—tests are known to involve more than one kind of ability to perform. According to Anastasi (1958): When an individual is classified on the basis of a single global score, such as an 1.0., there is still much that remains to be known about his abilities. Two persons attaining the same total score may present very different aptitude "profiles" when their performance along specific lines is analyzed . . . [and] the use of global scores may obscure or distort differences in separate abilities [4]. In a paper presented at the Twenty-fifth Anniversary Meeting of the Society for Research in Child Development (1959), Tyler and Jones maintained: . . . similarity in 1.0. does not mean similarity in subtest scores on the test from which an 1.0. is derived. In general, pupils do not score at similar levels on different parts of the test. For instance, for the boys in the Oakland Growth Study, the scores on each of the seven subtests of the Terman Group Test of Mental Ability were normalized with means of zero and standard deviations of 1.0. The standard deviations of the seven standardized, normalized scores for each boy were computed, and found to vary from .1 to more than 34 1.0. That is, we find considerable intraindividual variability in subtest scores of an intelligence test, and we find individual differences in the extent of this intraindividual variability [95]. Clements and Peters (1962) illustrated the growing awareness of the importance of the subtest performances within the gross 1.0. score when they wrote the following: We feel great errors are being made in the easy accept— ance by psychologists, as well as psychiatrists, pedia— tricians and social workers of an overall 1.0. score which so often misrepresents the child's potential. Many children have been readily classified as mentally retarded or merely average on the basis of the compos- ite WISC 1.0. when either the verbal or performance scores or some isolated subtest scores have been far above this [21]. Myklebust (1964) wrote an article to offer a new interpretation of available evidence concerning disabili— ties in learning and to propose a new terminology, "psycho- neurological learning disorders," for comprehensive classi- fication of such problems. In this article he wrote of the specificity of such learning problems, saying: The group is heterogeneous in that many types and degrees of learning disorders are present and in that many types and degrees of neurological disturbances are involved [70]. Thompson (1964) put it as follows: In some areas of development they are retarded; in others they are competent or even precocious. . . . If the child appears to be potentially within the average mental ability range but manifests persistent irregu- larities in learning and behavior, he may be considered for placement in a setting for the educationally handi- capped. Sometimes the estimate of mental ability must be presumptive because the child may not be able to mobilize or exhibit his abilities. Psychological test- ing does not always clearly identify children with potential learning ability [92]. And Yacorzynski (1965) wrote: 35 Another common characteristic is that the child may perform very well in some areas but be very deficient on other tasks. On intelligence tests, one may obtain an average or above average intelligence quotient, but the discrepancies among the items may range as much as 10 mental-age years. The child may, for example, pass some items at the 14 year level on the Stanford-Binet but fail some items at the 6 year level. The usual finding is that the visual motor perceptual tasks may suffer, whereas the verbal items may hold up fairly well [100]. Gallagher (1963) suggested that this new understand- ing of the specificity of sub-tests could be utilized in a positive way, that certain intelligence tests, or parts of them, could be very useful in planning for perceptually handicapped children: A more accurate title for "intelligence tests" [he said] would be "school aptitude tests" or "diagnostic tests." This describes what they can do and avoids the wholly unjustified inference that we have the genetic patterning of the child laid out before us in the form of an IQ score or pattern. . . . Another potentially more useful function for tests is to diagnose patterns of strengths and weaknesses in the development of an exceptional child. This information, if properly transmitted to the teacher, indicates where to begin a remedial program and what to include in the program. Again, just because a test gives a pretty profile of peaks or valleys doesn't mean that it is useful. This type of profile diagnosis must be validated through clinical practice and teaching experience, before it is accepted as valuable [33]. The case for variable development.—-A human body of any size is made up of a fantastic number of separate and distinct particles, clinging together according to a genetic pattern and carrying on the functions of life. For instance: the number of ggg molecules that occupy a volume of 22.4 liters, or about 6 U.S. gallons, at standard temperature and pressure is 600,000 billion billion [59]. 36 And molecules, of course, are clusters of atoms that are clusters of still smaller particles. A genetic pattern which guides development is more like a blueprint or a template than an immutable source of creation. The par- ticles that are available for construction according to the pattern vary with the particular host environment. Even if all the needed particles are available, there are still minute errors in such complex construction for a variety of physical reasons. In other words, it is well known that the patterns for genetic inheritances are not the same, but even if they were, the odds against any two developing per— sons ever being exactly alike are overwhelming. It seems that the only thing people absolutely have in common is difference. Both the design and the rate of construction are unique to the individual. If the various human organi- zations of mass and energy were distributed according to variation, they would form a bell-shaped distribution or a continuum as broad as the number of persons. The "normal," which is spoken of as if it were inherently the good, actually represents a £3222 of differences which accounts for a little over 40 per cent of the total population. Even the people within the "normal" portion of the distri- bution curve are not alike. They can only be classified there because the criteria for classification are less than specific. It must be seen that so—called "normal" development is not the only good development. The probabilities are 37 merely that a large portion of the population will develop at a rate that falls within the limits of the "normal" range. Some will develop more rapidly. Others will develop more slowly. Most of those who develop faster and slower than average will have potential for good health and intelligence if the environment is supportive. There is growing professional opinion that many children who are perceptually handicapped at earlier age levels may not be after a certain age. This suggests that the "normal" expectations are actually in error for this child who is on a different timetable of developmental growth. Crowther (1963) claimed that the physical bases for perceptual handicaps were often temporary and not due to damage but what he terms "cerebral dysmaturation" [25]. Myklebust [70], Wepman [96], and Honzik [43] also gave attention to the concept of variable development when they addressed the First Annual Conference on Children with Minimal Brain Impairment (1963). Myklebust acknowledged that the etiology of learning disabilities might be devel- opmental [70]. Wepman called for more research to find ways to distinguish between damage and developmental prob- lems [96]. And Honzik directed attention to an age-sex linkage which suggested maturational differences: It is clear from the description of the sample that twice as many boys as girls are diagnosed or suspected of having neurological deficits in infancy. This sex difference appears worthy of a more detailed considera- tion than can be given in this paper. One of the com- plicating factors is a possible maturational difference such that the newborn male may be more like a premature 38 and thus be more vulnerable and susceptible to injury. It is also possible that the male child's neurological development is slower than is true for the female, and that prematurity rather than impairment leads to the designation of "suspect" [43]. In an address before the section on neurology and psychology at the Southern Medical Association (December, 1965), Dr. Morris H. Lampert, a Texas neurologist and Instructor in Neurology at the University of Texas South- western Medical School, asserted the following: "The great majority of these difficulties are due to developmental or congenital disorders of specific brain function," he said, "almost invariably genetic in nature and seldom due to brain damage per se" [27]. Importance of early detection.--One of the major problems of perceptually handicapped children is "identity," because the average classroom is loaded with "normal" expectations. The average teacher expects certain behav- iors and achievements at a given age and the materials on hand are mostly "graded" according to what is usually expected that children of an age level will be able to work with. Even the performances of classmates establish what is "acceptable." The perceptually handicapped child is soon aware that there is a discrepancy between his performance and that of his peers. In ever so many ways the "feedback" from his environment constantly tells him that he is out— of-step. He can't do what most of the others in his group can do. The others win the teacher's approval while he senses or is sometimes told that he is unworthy. For lack 39 of understanding of his difference the teacher may suspect and sometimes openly accuse him of laziness, inattention, or willful wrong-doing. According to Thompson (1964) this situation is often repeated and reinforced by the home: It is far too easy to fit in with or to extend the child's unhealthy modes: clowning, cheating, demand- ing, perseverating, compulsive dependency, sweetness, neatness, cleanliness, etc. These avenues, among many, are not recognized as defenses against the pain and anxiety and inadequacy that he feels [92]. Researchers at the Marianne Frostig School of Educational Therapy, Los Angeles, who developed and standardized a per- ceptual quotient, found that children in kindergarten and first grade with low P.Q. scores are likely to have diffi— culty in learning to read and to be poorly adjusted in school [75]. The period of maximum visual perceptual development normally occurs between the ages of 3-1/2 and 7-1/2 years. . . . In a group of 373 kindergarten children, for example, we found a significant correlation between scores in the lowest quartile on the perceptual test and teacher ratings of maladjustment in the classroom. The same was true of a sampling of 277 first grade children. We have also found that in children with visual perceptual handicaps, the ability to pay atten- tion is decreased [32]. 'Tompkins (1963) proposed a link between undetected percep- tual handicaps and juvenile delinquency: In our highly literate, technological society, the child who cannot learn to read soon realizes that he is disinherited, economically as well as socially, and it is no surprise to discover, as the New York City Children's Court discovered in 1955, that seventy-six per cent of the juvenile delinquents whose cases came before the court were two or more years retarded in readin , and over half were retarded by five or more years 93]. 40 Tompkins also proposed that adequate diagnosis and remedial help, soon enough, is very unlikely: One of the main obstacles in treating childhood reading disorders, apart from the grievous shortage of trained remedial teachers, has always been the fact that children rarely come for help until they have already experienced several years of humiliating failure in school. The public school system in New York (for instance) will not even refer a child for remedial help until after third grade, and by that time he has often developed severe neurotic symptoms . . . at the moment . . . the outlook for children with dyslexia is fairly discouraging. Some of them--whose disability is mar- ginal or is mainly the result of delay in normal maturation--will always manage to pick up reading in the later grades, provided their frustration and anxiety in the meanwhile do not cause too many emo- tional obstacles. . . . The majority will go untreated, and will probably grow up believing that they are hope- lessly dull-witted [93]. Certainly poor visual perception and the resultant inability to learn to read are major blocks to learning. But, as was pointed out earlier, there are many other types of perceptual handicaps. Whatever the basic cause or com- bination of causes, it is important to diagnose the diffi- culties and begin remedial measures as early as possible. Only in this way can the undesirable emotional complica- tions that inevitably result from failure to learn be avoided. In an interview for Psyghiatric Progress, Laufer (1966) reported on neuropsychiatric evidence gleaned from twenty years of work with hyperkinetic children: When hyperkinetic impulse disorder is not recognized and treated as a distinct organically based entity, adverse reactions to a child's disruptive behavior are likely to culminate in serious emotional dysfunction. . . Diencephalic dysfunction is capable of making the CNS [Central Nervous System] unduly sensitive to stimuli 41 pouring in from both peripheral receptors and viscera. . . . As a consequence. . . . The child often creates turmoil . . . his aggressive motility may generate anxiety in parents. If they react with hostility and then guilt, the child's difficulties are increased. Among children whose parents are not sensitive to excessive activity, the problems begin in school, which imposes restrictions on movement and where the hyper- kinetic's short attention span affects other children acutely. The problem is complicated in many children . . . by learning disabilities that stem from concomi- tant cortical involvement leading to visuomotor dys- function. . . . Dysfunction usually clears up sponta- neously as a child reaches maturity. . . . [but] When symptomatology has been of long duration at the onset of treatment . . . the child . . . may require not only medication and special schooling, but psychotherapy [6]. Summary.--At this point in time there is a lack of data from really comprehensive studies for drawing statis- tically sound conclusions about the relationship between perceptual handicaps and 1.0. However, there is sufficient evidence in the form of professional conclusions, case studies, and test records to allow for the formulation of a good working hypothesis. What evidence is available points to a very favorable correlation. The great majority of individuals with perceptual handicaps, including those who definitely have brain damage, are believed to have near- average, average, or above—average intelligence. The evi- dence for this is substantial enough that several general definitions have recently been constructed with statements to this effect included as a basic premise. Perceptual handicaps accompanied by lower than average 1.0. certainly appear to be exceptions to the rule. It is much more likely that a good general intelligence is present and can 42 function well, sometimes in a superior fashion, if certain unique provisions are made. 'And there is now good reason to suspect that the imperfect instruments and procedures for measuring 1.0. have led to labeling as retarded many children who only had learning problems, not a lack of intelligence. Further, it is believed by many profes- sionals in the field that global 1.0. test scores provide very little useful information for the classroom teacher. It is proposed by some that careful analysis of sub-test scores can help to diagnose patterns of strengths and weak- nesses in the development of children with perceptual dif- ferences. They caution, however, that even this type of "profile" diagnosis must be validated through clinical practice and teaching experience before it can be accepted as valuable. Accumulating evidence is more and more dis- counting the belief of widespread "damage" or "injury," in favor of differential development. A number of profes- sionals in the field have proposed that some children who are considered to be perceptually handicapped in early grades are actually just growing in a healthy way on a slower timetable than most of their peers. It is how they are usually regarded when they don't match the "norms" that most often induces an emotional handicap that can outweigh and outlast the basic learning problem. Perhaps the most important problem of perceptually handicapped children is "identity." The children are soon aware of the discrepancy between their own performance and what is "normally" 43 expected. For lack of understanding of such differences teachers may suspect and sometimes openly accuse percep- tually handicapped children of laziness, inattention, or willful wrongdoing. The humiliation of constant failure and negative treatment by "significant others" soon induces neurotic symptoms which generally get worse as time goes along. Yet the basic cause or causes are unknown and unmanageable by the child. He cannot perform as expected. Neither can the teacher do much about it without adequate diagnosis so that she can devise remedial help in terms of the specific and unique‘learning problems involved. Aside from the fact that the democratic philosophy of valuing individuals calls for action, now that the problem is visible, the magnitude of the problem and its cost to the rest of society in leaving it unattended are far too great to ignore. The resultant neurotic behavior and stunted personalities are also a serious danger for society. CHAPTER IV DIAGNOSING PERCEPTUAL HANDICAPS Behavioral symptoms to watch for.--Writing for ESCALON, INCORPORATED, a non-profit organization formed in 1959 which operates clinic schools for children with learn- ing and behavior problems, Thompson (1964) proposed: Classroom teachers can readily nominate most (percep- tually handicapped) children by their behavior. They are to be found in almost every classroom. Learning and behavior problems exhibit themselves in many ways: inattention, hyperactivity, disobedience, defiance, poor grades, refusal to complete work, daydreaming, annoyance to other children, and agitation or exclusion on the playground. The teacher can refer to the school counselor or psychologist those children who are not adapting to or profiting from regular classroom proce- dures. In turn, the psychologist can investigate the condition in detail: background, educational history, academic achievement, medical evidence, family circum- stances; and mental, emotional, and motor functioning. If in any of these areas of examination the child per- forms within or above the average range of ability, we may suppose that there are potential strengths within his make-up that might properly be exploited toward rendering him an adequately functioning child [92]. Friedman (1965) offered a list of characteristic behavioral symptoms (see Appendix I) along with a word of caution to observing teachers: As a classroom teacher, you may note some of the following behavior characteristics often seen in these . . . children. The observation of some of the follow- ing should not lead you to conclude on your own that this is a . . . [perceptually handicapped] . . . child but rather these should serve as an alert so that you may refer this child to your school psychologist for further evaluation [31]. 44 45 Clements and his associates (1965) conducted a search for symptoms of perceptual handicaps by reviewing over 100 pieces of literature. They found a total of 320 symptoms which were attributed to, or said to be charac- teristic of, the disorder(s). Trying to eliminate overlap and duplication, and group the rest of the symptoms into meaningful patterns, they developed a listing of Prelimi— nary "Signs and Symptoms" Categories (see Appendix II). Recording observations.--In order to do the most good for the child involved, diagnosis must be as accurate as possible at all stages. Classroom observations are the foundation upon which other diagnostic activities will be built. Recording observations at the time they are made reduces error and distortion in basic information about the child's behavior. It is also helpful to make observations in both qualitative and quantitative terms, noting what specific behavior occurred and how much of it. This is often diffi- cult for the classroom teacher since she has a lack of uninterrupted time for classifying what is seen and getting it recorded. As a result of this situation, Burks (1965) constructed a Behavior Rating Scale (see page 46) for use by classroom teachers. It [the scale] was designed specifically to gain an estimate of that behavior which might spring, in part or whole, from organic pathology of the central nervous system [17]. Though many would think the diagnostic claims for this 46 BEHAVIOR RATING SCALE [1 7] (Devised by Harold F. Burks, Ph.D.) Name of Child- -. __ "I I- 1.- Age Grade Teacher.__ m ___._ School Date Please rate each and every statement by putting an X in the appropriate square after the statement. The squares are numbered from 1 to 5 and represent the degree to which you have noticed the described behavior. The bases for making a judgment are given below: (1) You have not noticed this behavior at all. 2) You have noticed the behavior to a slight degree. (3) You have noticed the behavior to a considerable degree. 4) 5) You have noticed the behavior to an uncomfortable (large) degree. You have noticed the behavior to a very large degree. Rating Scale Seemingly not affected by extremes of heat or cold........_ Poor coordination in large muscle activities (games, etc.)...... Confusion in spelling and writing (jumbled). inclined to become confused in number processes. gives illogical responses . Reading is poor . .. ._ . Hyperactive and restless Behavior goes in cycles .. . Quality of work may vary from day to day Daydreaming alternating with hyperactivity Excessively meticulous, exacting formalistic or pedantic 11. Erratic, fligbty or scattered behavior . .. 12. Lacks a variety of responses repeats himself in many situations ,. , 13. Easily distracted lacks continuity of effort and perseverance .. . ......................................... 14. Cries often and easily 15. Explosive and unpredictable behaviOr 16. Often more confused by punishment 17. Upset by changes in routine 18. Confused in following directions .. 19. Tends to be destructive, especially of the work of others 20. Demands much attention . .. .. 21. Many evidences of stubborn uncooperative behavror 22. Often withdraws quickly from group activities; prefers to work by self . ........................... 23. Cannot seem to control self (w ill speak out or jump out of seat etc.) .. 24. Constant difficulty with other children and or adults (apparently purposeless) .. 25. Shallow feeling for others 26. Seems generally unhappy .. 27. Confused and apprehensive about rightneSs of response indecisive .. . . .. .. 28. Often tells bizzare stories .. . . . 29. Classroom comments are off ten “off the track" or peculiar 30. Difficulty in reasoning things out logically with others H 47 instrument presumptuous, they would nevertheless applaud its systematic approach to classroom observation. For as Capobianco (1964) pointed out: Rating scales . . . force an orderly account of the children's behavior. These instruments provide insur- ance against the tendency, on the part of many observ— grsi to record only the negative aspects of behavior 19 . Many such schemes are possible for recording observational data. Experienced teachers should be encouraged to add categories and/or synthesize their own procedures. But the objectives should always be the same: (1) accuracy, (2) clarity, and (3) availability. All three are important for adequate diagnosis and, ultimately, for proper help for the child involved. Friedman (1965) proposed that after making thorough classroom observations the next step should be: . . . to call in the parents and discuss what you see in the classroom that suggests to you that their child is having some learning problems. Perhaps they can tell you something about this child's behavior at home that makes him a little different from their other children. You should attempt to get as much informa- tion as possible about the nature of pregnancy, birth,' medical and developmental history so that any injuries which the child has sustained will be noted, and any unusual patterning in his development will be noted, also. This, in particular, in terms of the age of walking, onset of speech and toilet training. Your special education department probably has a list to serve as a guide line for this conference as these are very important items in helping to make a differential diagnosis. Remember, at this point the child has not yet been diagnosed, and while you may suspect what the trouble is, you should be wary of suggesting what you have in mind before the results of a neurological exam— ination and psychological testing come through. A faulty diagnosis can do a great deal of harm [31]. 48 The teacher's limitations in diagnosis.--From an educational point of view, the objective of diagnosis is to lay a foundation for the planning of an educational program that will develop the child's abilities and help him to compensate for his disabilities. What is needed as a basis for educational planning is a systematic inventory of the child's level of development in perceptual and motor func- tions, in communication, in concept formation, and in social interaction [89]. It has been pointed out that the classroom teacher can make important, even crucial, observations. She can gather information from the parents and counsel with them. She can also add the results of psychometric testing to the cumulative records. However, it must be emphasized that this does not constitute diagnosis, and the teacher alone cannot make an adquate diagnosis. Adequate diagnosis of perceptual problems calls for specialized skills and facilities far beyond the scope of the teacher and the classroom situation. This is not to belittle the classroom teacher. In fact, the positive use of adequate diagnosis information will ultimately rest upon the skills of the teacher in interpreting such information into appropriate learning experiences. But such skill is in vain if the basic information about the child's problem is faulty or incomplete. 49 A competent classroom teacher is a wonderfully flexible and inventive person. The chances are strong that if furnished with accurate information about a child's specific learning problem she will create ways to help him learn how to learn. As Homans has put it: If the analysis is adequate, a way of dealing with the situation will suggest itself [42]. This does not necessarily mean that the teacher will create what is needed "out of thin air," although her background of experience is often good for a great deal of productive "conjuring." Rather it means that the good teacher is always engaged in "research" on problems that she recog- nizes as important. She is always looking, reading, ask- ing, and putting together in terms of the specific thing she wants to deal with. If one creation falls short of her goal, she quickly reorganizes and tries something else. This methodology is somewhat like hunting for four-leaf clovers--it helps to look where clover grows. Adequate diagnosis can "put the teacher in a clover patch" that is impossible to find without expert guidance and specially constructed maps. Reed (1963), however, warns that playing the role of diagnostician can become "heady" stuff and points out: [An] . . . example of pseudo-sophistication can be seen in the concept of "minimal brain damage." This concept would seem to imply that neurological criteria exist which will reliably differentiate groups of children on the basis of the extent of brain lesions. There is the additional implication that extent of brain lesion is an important determinant of intelligence and learning ability. In actual practice, children with "minimal 50 brain damage" are generally identified on the basis of their behavior in a school situation with little regard for outside criterion information [79]. A statement by Kephart (1963) illustrated the inherent danger of incomplete diagnosis: Particularly with the minimally damaged child, it seems possible that much of our difficulty in teaching is due to the fact that we have started too high and not laid an adequate foundation for the learnings which we are requiring [53]. Working with the pgrents.--After a consultation and gleaning of information from the parents, the teacher should advise that the next positive step is for the parents to have their child tested by a school psychologist to gain further important evidence of the specific nature of the problem. It is a good thing to work closely with the parents throughout the diagnosis because dealing effec- tively with perceptual handicaps is a job best done in cooperation with the home. If the teacher needs highly specialized information in order to provide the right environment for the child, it stands to reason that the parents need it too. Besides, it may be possible to obtain certain diagnostic information only through full coopera- tion of the parents. If there is not a school psycholo- gist, for instance, it may be necessary to arrange with the parents for the use of facilities outside the school system, at a university clinic or at the office of a con- sulting psychologist. 51 The psychometric examination.--The minimal psycho- logical test battery that a teacher should request for a child is the complete Wechsler Intelligence Scale for Chil- dren (WISC), the Bender Visual Motor Gestalt, and a stan- dardized reading test such as Gray's or Gates' [21]. The over-all I.Q. score as measured by the WISC is not as useful, according to Clements and Peters (1962), in diagnos- ing specific perceptual problems as is the sub-test pattern of performance: Thus far we have isolated 3 principal patterns. The most common pattern is scatter in either or both the Verbal and Performance ScaIes (WISC Pattern I). Low scores (relative to others) most frequently occur in Arithmetic and Digit Span in the Verbal Scale, and Block Design, Object Assembly, Coding, and Mazes in the Performance Scale. . . . The second most frequent (WISC) pattern (WISC Pattern II) is that in which the Verbal I.Q. is 15 to 40 points higher than the Perform- ance I.Q. . . . The third and least frequent pattern (WISC Pattern III) is the reverse of WISC Pattern II, i.e., the Performance 1.0. is 10 to 30 points higher than the Verbal 1.0. Such a child has difficulty in expressing himself verbally. . . . In our experience, the child with WISC Pattern III invariably has dyslexia. The Bender Visual Motor Gestalt is here used as it was intended, that is as a measure of perception and visual motor coordination. . . . We have found that the failure to obtain a Bender-Gestalt has sometimes led to a wrong diagnosis and treatment plan. . . . We believe that it or an equivalent measure should never be omitted. . . . Gray's Oral Reading Paragraphs are pre- ferred as a measure of sight reading because of their simplicity of administration and content of the para- graphs [21]. Among other instruments for measuring visual perceptual functions are the Advanced Tests of Visual Perception by Getman and Kephart (1953) and Kephart's Perceptual Survey Rating Scale (1960). In the area of language functions, 52 Kirk's Illinois Test of Psycholinguistic Abilities (1961) provides a systematic analysis of the basic aspects of language [89]. Thompson (1964) also suggests using the WISC and Bender-Gestalt but emphasizes the limitations of such devices: There are many tests now in existence that help to identify visual-perceptual impairment. Among the bet- ter known are certain subtests on the WISC and the Bender-Gestalt Test. It seems reasonable to suppose that if children give evidence of average or above— average mental ability in several areas but are unable to read adequately or to discriminate or reproduce form at a level commensurate with other aspects of their development, some kind of visual-perceptual impairment exists, especially if it has been determined that vision is not involved. It has been widely assumed that children who are not able to read and who give evidence of inability to dis- criminate have visual problems. Experience has shown that most of these difficulties have little if anything to do with vision as a function of the eye. Although many . . . [perceptually handicapped] . . . children do have vision problems, in themselves these problems seldom seem to stand in the way of learning to read or to interpret visual material accurately. Most poor readers appear to have equal facility with good readers in the mechanics of optic perception, but poor readers have difficulty patterning such perceptions, and in differentiating figure—ground and right-left discrimi- nation. What may be the case is that eye defect is only one of several signs of basic impairment [92]. The medical examination.--A complete medical exami- nation is also needed. And here, if not before, the parents will be vitally involved. If at all possible, the parents should arrange for and take the child to have the medical exam. The parents should explain to the doctor that a learning problem is the reason for the examination. They should give as much information as possible to assist 53 the doctor in searching for related medical symptoms and identifying a particular symptom pattern or syndrome. According to Grover and Allen (1962): This syndrome is not often recognized by the family physician, the pediatrician or the neurologist. This is because the patient's parents are so obsessed with the patient's emotional problems that they often omit or minimize the historical information which would suggest the organic character of the child's problem. Usually, unless this is drawn out of them, the exam- iner may totally miss the true significance of the difficulty [37]. No good reason is seen why duplicates of the teacher's observations, information gleaned by the teacher in con- sultation with the parents, and reports of the psychologi— cal evaluation should not be made available to the parents when they take the child for medical examination. This would give the doctor something substantial to go on and the parents would be facilitated in acting constructively on behalf of the child. Multi-disciplinary evaluation.--Many professionals concerned with perceptual problems in learning have agreed that the diagnostic steps thus far discussed are indispen- sable. At best they represent a minimum of systematic information-gathering necessary for intelligent educational planning for an individual. Most professionals in the field today also agree with the concept of multi- disciplinary diagnosis expressed by Jones (1963) at the First Annual Meeting of the Conference on Exploration into the problems of Perceptually Handicapped Children: 54 Children with perceptual difficulties are too complex in their behavior and emotional reactions, too variant in their abilities and skills for anyone to ever think that diagnosis or prognosis could be a simple matter. The very process requires the evaluation and discussion of various groups of professional people, to say nothing of the information which might be, and must be, collected from the parents and those within the child's home, in his school, and in his community. After this big job comes the job of remediation, the job that is done in the classroom, the job that must be done by the teacher to evaluate the abilities of the child and to Estgblish an environment in which the child can learn 50 . This belief was reiterated by Lehtinen (1963) in another address at the same conference: The perceptually handicapped child's varying needs are there too, yet he is all too often being treated seg- mentally by the different disciplines involved without a coherent, overall treatment plan. . . . The most secure results have always been attained in these situ- ations in which education, psychology, social work and medicine, not to mention the parent, have recognized that this is a mutual problem and that while each can contribute from its unique competencies to the under- standing of the whole, the most effective treatment develops from their integrated efforts [63]. Gathering, classifying, and coordinating various kinds of pertinent information about a child set the stage for adequate diagnosis. Next should come a comprehensive evaluation by a multi-disciplinary team. By far the best situation for such evaluation is the special clinic which is part of, or working closely with, a university medical center. Such a clinic offers the insights borne of much experience with such problems as well as access to a wide array of technical equipment such as the electroencephalo- graph. Involved in continuing research, clinic personnel 55 are often alert to "soft" signs and subtle deviations that might otherwise go unnoticed. It has been experienced that while a number of such clinics are available and willing to conduct such diagnoses upon request there has been a problem of visibility to the public. There has been a serious lack of coordination between such facilities and the guidance and counseling facilities in the same community. Part of this lack of coordination may be due to the unfortunate use of patholog- ical labels, such as brain "damage" or "injury" in describ— ing clinic facilities and reporting research done there. Perhaps under such pathological labels the clinic facili- ties have appeared to be unsuitable for diagnosis of "mere learning problems." Several parent groups have recently founded organi— zations to assist in distributing information about percep- tual handicaps. Some of these groups are also working to coordinate or develop facilities for adequate diagnosis and treatment. Two notable examples are The Fund for Percep- tually Handicapped Children, Inc. (Evanston, Illinois) and the California Association for Neurologically Handicapped Children. And the Association for Children with Learning Disabilities, Inc. reports that it now has become an inter- national organization for such purposes. Until such time as there are sufficient clinics for diagnosis of perceptual handicaps, the coordination of local agencies and facilities seems the best alternative. 56 Various school districts in Oakland County, Michigan, for instance, have established a multi-disciplinary screening committee to evaluate diagnostic evidence. Included on such committees are the classroom teacher, a school psy- chologist, a social worker, the County Director of the Perceptual Development Program, and sometimes the family doctor or other medical specialists with an interest in the proceedings. The Oakland County Schools are among the pioneers in developing programs for perceptually handicapped children. Their level of organization for such activities is far beyond that found in most communities. It was recently observed, for instance, that a large school system in an upper middle class community had to share only one county- level psychologist with several other school systems. This meant up to a year and a half delay on referrals for psycho— logical testing. This school system was within five miles of a Big Ten University, and some of the parents were teachers in the College of Education there. However, observations were made in an under- privileged community where there was no psychologist or even cumulative records for the children. But even so it was possible to locate a diagnostic clinic at a university some twenty miles away, and it was possible to convince the director of the clinic that conducting diagnosis on a num- ber of the most severely handicapped students in the school would be a valuable experience for clinic interns and give 57 some needy children a real break. The school board furnished a bus, and the teacher, with the assistance of parents, took the children to the clinic on Saturdays. It certainly wasn't the best situation, and many of the chil— dren with milder handicaps were never examined. The story is offered to illustrate that the multi-disciplinary approach, which is so vital to adequate diagnosis, can occur even where it never has before, even under adverse local conditions. It is possible and seems likely that as the problem (area) of perceptual handicaps is better understood and the clinic services become known to the public, taking children to comprehensive clinics for diagnosis will eventually become the rule rather than the exception. That day will be a great day in education, provided the schools can learn how to develop and utilize methodologies as adequate as the diagnostic information they will get. Summagy.--Classroom teachers can readily identify most perceptually handicapped children by their behavior. They can make systematic observations and record these for thorough evaluation. They can visit with the parents and obtain important information about the home environment and the child's developmental history. But teachers cannot make an adequate diagnosis. Adequate diagnosis of percep- tual handicaps calls for specialized skills and facilities far beyond the scope of the teacher and the classroom 58 situation. Thorough medical and psychometric exams are needed. The school should cooperate with and assist the parents in obtaining diagnosis. If teachers need highly specialized information in order to plan effectively for an individual child, the parents need it too. Perceptual problems are not often recognized by individual doctors unless the learning problem and its pertinent details are discussed with him before the medical exam. For this rea- son the school needs to assist the parents in providing the doctor with a clear and accurate accounting of the informa- tion gathered by the teacher. Classroom observations, home consultations, psychological testing, and medical exams set the stage for adequate diagnosis. Evaluation of all this information is best done by a multi-disciplinary team, preferably at a comprehensive clinic which is part of, or working closely with, a university medical center. Some school systems have established multi-disciplinary screen- ing committees made up of various professionals in the community. While this may be the only alternative now available in some areas of the country, parent groups are rapidly organizing to distribute information and develop better facilities. It seems very likely that as the prob- lem of perceptual handicaps is better understood by society- at-large and clinic services become visible, most children with learning problems will be taken to such clinics for comprehensive diagnosis. The challenge to education is to develop and utilize methodologies as adequate as the 59 diagnostic information that will be obtained (for an outline of steps to take in adequate diagnosis, see Appendix III). CHAPTER V EFFECTIVE LEARNING EXPERIENCES FOR THE P.H. CHILD The residential school.--It must be emphasized that very few children need to be placed in a residential school situation. Probably less than 2 per cent of the total elementary school-age population have perceptual handicaps severe enough to warrant special (segregated) classes of any type. And, if at all possible, even these special classes should be an integral part of the public school programs. But some communities do not have adequate facili- ties, public or private, for dealing with perceptually handicapped children. In fact, most public school systems have not yet recognized perceptual problems in learning as legitimate concerns for curriculum consideration. When parents in such communities have been able to secure diag- nostic services and have found that their child needed individualized educational experiences not locally avail- able, the residential school has offered a way to obtain adequate education for the child without uprooting the whole family. In some cases the emotional problems that have developed in the home concerning the perceptually handicapped 60 61 child are severe enough, and so unmanageable under the circumstances, that residential placement is the only real hope for the family and/or the child. The Cove School at Racine, Wisconsin, is an out— standing example of a residential school for children with perceptual handicaps. The students at this school come from all over the nation. It represents one type of pro- gram resource that can be utilized when the need is great and the local facilities are unsatisfactory. It has been estimated that less than .1 per cent of the total elemen- tary school-age population has need for such residential placement. The special day school.--In some communities special day schools are available for children who are unable to make satisfactory progress within one of the existing pub- lic school programs. The number of children of elementary school age who need special class placement of some type has been estimated at no more than 2 per cent. This does not mean that the special day school is being promoted as the most satisfactory answer for these children. In fact, many respected professionals strongly suggest that it is not. It seems that special day schools have developed where adequate action by a local school system was missing. They have been private answers to problems unrecognized and/or unsolved by the public institutions. 62 The Cove School in Evanston, Illinois, founded by the late Alfred A. Strauss, and now under the direction of Dr. Laura Lehtinen, is an example of the special day school. It is affiliated with the Cove (residential) School in Racine, Wisconsin. The Evanston (Cove) school was in existence long before the local public school system became aware of the need for special curricula for percep- tually handicapped children. Once the public school system did recognize the need for special provisions for some stu— dents, they arranged to work in cooperation with the Cove School rather than to duplicate these facilities at public expense. In other words, a previously existing private school now functions as an integral part of the total pub- lic school program for perceptually handicapped children. The Tulsa Education Foundation School of Tulsa, Oklahoma, is another example of the special day school. It was established in 1957, to provide: . . . educational facilities for children with normal or above intelligence who are unable to progress in a regular school program as a result of a learning dis- ability. . . . The primary aim . . . is to help the child overcome his learning disability so that he may be successfully integrated into regular public school programs. The Foundation School works c00peratively with the Tulsa Public Schools. . . . A total public school program is desirable but hampered . . . [under present circumstances] [48]. Segregated classes.—-Severa1 public school systems have established special classes within the regular school situation. These classes are most often under the direc- tion of departments of special education. For example, The 63 Perceptual Development Program of the Oakland County, Michigan, Schools includes such special or segregated classes and is administered by the County Department of Special Education. The classrooms used for the program are strategically located in several elementary school build- ings so students can identify with the public school and be integrated into normal classroom situations as much and as soon as possible. And the records at Oakland County show that rehabilitation to the regular classroom situation is accomplished by most students after two or three years of "learning how to learn" in this special program. The residential school, the special day school, and the special class within the public school are basically the same kind of special provision. They may be private, semi-private, or public, but objectives and methods are very much alike and approach the ideal in individualizing education. The number of students in such a classroom is usually held to about eight. There is often a full-time teacher-aide. A new class is usually started with only one or two students, the teacher taking time to know each stu- dent thoroughly and making sure they are fully established before others are brought in. This process is repeated until the full compliment of eight is enrolled. A variety of materials and methods are creatively utilized to meet each individual's special needs, many of these resembling or actually stemming from Montessori materials and methods. But by far the most potent resource in any case is the 64 creative teacher who: (1) gets to know the individual student intimately as a person and uses the comprehensive diagnosis information as a basis for finding out just where and how a child's learning is blocked, (2) has a wide back- ground of educational theory and methods to draw from-- including special theories and methods for working with perceptually handicapped children, and (3) can innovate ways to help a child learn in spite of whatever handicaps he may have. The primary aim of most special classes is rehabili- tation and eventual return to the regular classroom. This usually involves considerable cooperation with the regular classroom teacher and is best accomplished a little at a time, increasing involvement as the child is able to cope with it. Fundamental skills in language arts and calcula— tion are most easily identified as the subject-content of special classes for the perceptually handicapped. Physical therapy-orientation experiences are provided, with some schools having a professional therapist on the permanent staff. But the overwhelming emphasis is on personal organi- zation for increased independence in learning. The itinerant teacher.--It has already been pointed out that only about 2 per cent of elementary school-age children need to be placed in special (segregated) classes of any type. Yet, up to 25 per cent (see Chapter II, pages 18-19) of this age group are believed to have some degree 65 of perceptual handicap that interferes with normal (expected) learning under the usual classroom circum- stances. This means that the regular public school cur- ricula should make individualized provisions for up to 23 per cent of the elementary school-age population. Provid— ing a special teacher who meets with certain children for portions of the school day is one method used to deal with those whose learning problems are felt to need more special attention than the regular classroom teacher is able to provide yet are not severe enough to warrant special class placement. The Public Schools of Evanston, Illinois, employ such a plan. Small special rooms are provided in elemen— tary school buildings--much like the usual speech-therapy facilities. One, two, or three students at a time, depend- ing on similarity of needs and personal compatibility with each other, leave the regular classroom to work for an hour or so in the special room. As with the special (completely segregated) classes mentioned previously, program emphasis is on fundamental skills of language and calculation, and increased independence in learning. The special teacher in this kind of program works cooperatively with the regular classroom teacher, reporting on individual needs and prog— ress and acting as a resource consultant. In some cases the special teacher works closely with the physical educa- tion teacher(s) to plan therapy-orientation experiences that can be provided for individuals in P.E. classes. 66 Individualizing classroom experiences.--Whatever has been learned from educational research, it is certainly clear that no single method of instruction is best for all children: Although there are many ways to individualize teaching, we must be certain that whatever we do is based on the premise that each child is unique. Not only does he learn at his own rate but he learns in his own special way. Since his background is different from that of any other child, he will approach learning in a manner unique for him [78]. A good classroom should have a number of activity centers and some clear, easy to follow, routines for their basic use. Beginning days of school should be used for orienta- tion to these centers and routines. This makes possible a variety of forms of grouping for independent activity after whole class discussions and planning sessions have taken place. Success with this approach lies in the ability of the teacher to set children at tasks so absorbing that she may be free to deal with the always abundant instructional problems of individuals. With most children working quietly by themselves, the teacher can then work closely with small groups of children having similar problems or with a single child (for six flexible grouping techniques, see Appendix IV). This type of grouping procedure sets the stage and provides the opportunity for individualized edu- cation. It does not, however, guarantee it. Subdividing students in a classroom into smaller groups has no virtues in and of itself. It makes sense only when a particular grouping arrangement facilitates the attainment of a specific educational goal. Effective 67 use of grouping requires the teacher to be clear as to purpose. . . . Whatever the size of the group, the individual learner is the focal point. The reason for placing him in a particular subgroup of a particular size is to help him with some aspect of his learning. In this matter of classroom grouping, the future will probably witness less attention to achievement as the within-class pattern of grouping, less and less conform— ity in the design of class groups, and more provision for individual learners to proceed at their own tasks at their own rates of speed [84]. The classroom teacher who has suitably educated and organ— ized her total class of 25 to 30 students, so that she is essentially able to function for a time as a special teacher with one to eight students, must then adapt and utilize the methods and materials that the good special teacher uses. No attempt will be made at this point to describe the special materials needed for working with perceptually handicapped children. (A list of commercial supply houses that can furnish adaptable materials and a listing of teacher-developed concepts for devising materials are included in Appendices V and VI.) By far the best source of appropriate materials is the inventive teacher who per— ceives the special need and shops the local department and hardware stores until something suitable is found, or enlists the aid of the school services department in con- structing aids of her own design. The fundamental method that is called for is actually appropriate to all students for maximum learning progress. Some students can learn without it—-they always have. But it is absolutely essential to those with 68 perceptual handicaps. Having a variety of activity centers, thorough orientation to established routines, and grouping for independent study are techniques that allow for the use of exploration and discovery method: Exploration and discovery invite involvement. Involve- ment in turn, invites questioning, and the spirit of inquiry invites and compels search. The questions raised, however, must be real questions whether they are asked by teacher or pupII. . . . It is through insightful questioning that the teacher may release the learner . . . may help him to "open up" to the world; may sensitize him to those aspects of his environment which have not been brought into the focus of his per— ceptual field . . . errors and mistakes are viewed as incomplete learnings rather than as shortcomings or occasions for humiliation, reprimands, or low marks. Incomplete learning becomes the clue for the teaching- learning focus, for clarification of perceptions . . . if children are to uncover their full potential, they must be helped to see themselves honestly but accept- ingly. . . . The teacher gains rather than loses in importance as he operates in this way. . . . To his general knowledge about children and the way they learn, he constantly adds specific information about each individual whom he observes. He moves from the role of teller to the role of suggester, he becomes a provider of stimuli, a raiser of questions, a sage wise enough to step aside at times to allow the learner to find a way through the problem, but he remains always a support when the pupil has lost momentum [46]. This method is certainly not foreign to the competent. elementary teacher. Such teachers have always employed it to a large extent. This point of view is supported by the criteria for selection of special class teachers for the Oakland County (Michigan) Perceptual Development Program: The teachers for the . . . Program are chosen because they are good elementary teachers who have worked well with children in a group situation or individually, know beginning academic skills of young children, and have a variety of skills and creativity in executing classroom instruction [80]. 69 Special education vs. individualized education.--It has been pointed out that special education was developed to deal with problems not being recognized and/or dealt with properly by the regular public school classes. This was not to say that special classes are the best way to deal with most perceptually handicapped children or to con- done the lack of provision in the regular classes. On the contrary, many professionals, even some in special education, feel that many special classes are stop- gap devices rather than something desirable to be promoted and expanded. Except for an extremely small number, atypical children are more like normal children than they are different. And they are properly the concern of regu- lar classroom teachers and administrators before becoming the concern of specialists. . . . in practice an artificial dichotomy has developed which separates learners into two groups. Such a divi- sion--into those pupils "in the regular program" and those pupils "in special education"--ignores the con- tinuum of individual differences and fractionates many aspects of educational effort. One consequence is that general curriculum workers tend to lack an awareness of the need to break down conceptualization processes into substeps for many pupils (and the contributions from Special Education to this need): while special educa— tion curriculum personnel tend to concentrate on spe- cialized methods for immediate goals with a lack of awareness of the need to develop depth and sequence [68]. Another important question is whether by taking children out of the regular classroom they, and those who remain behind, are being deprived of some experiences which are vital in their education for citizenship and valuable 70 in the development and use of their abilities [44]. When children are segregated for any reason: . . . it is difficult for them to acquire a feeling of oneness with their fellow men. It is important that . . . [there be] opportunities for interaction with people who are different, in an atmosphere where dif- ference is valued rather than feared. . . . To the extent that an assignment to an ability group pegs a child as to ability and status, it tends to reinforce feelings of either inferiority or superiority, neither of which is conducive to the development of fully func- tioning people [73]. Guide for individualizing programs.--Thorough multi- disciplinary diagnosis should set the stage for prescribing what educational program is most appropriate for a percep- tually handicapped child. It is not a case of adopting one program to the exclusion of the rest. Ideally, it should be possible to prescribe, as needed, any one or any combi- nation of the programs previously described in this chap- ter, from residential placement to individualized instruc- tion within the regular classroom. It is not likely, how— ever, that exactly appropriate prescriptions can be carried out in most communities at the present time. What can be done must necessarily be in terms of existing facilities. But, the goal should always be to offer the best treatment possible according to comprehensive diggnosis and under the local circumstances. And, if the right facilities are not available, plans should be instituted at once to establish them at the earliest possible date (see Chapter VI for recommendations for program development). 71 In the meantime, many teachers will be faced with the need for individualizing educational experiences in the regular classroom as perhaps the only means available for doing anything positive for the perceptually handicapped children in their charge: This requires the teacher to think of himself as a learner who needs to explore his student's perceptions of the subject and themselves so that he can give special treatment to the individual [61]. It is recognized that already difficult work—loads are assumed by most elementary teachers. While they are generally quick to acknowledge the desirability of meeting each child's needs within a regular classroom situation, most are honestly convinced that this is an unattainable ideal under the circumstances. What is being suggested here is that one of the existing circumstances can be altered at the teacher's will to allow much greater atten- tion to individuals. A laboratory school situation has been observed wherein the classroom teachers were assisted at all times by one or two student teachers and two or three part—time participating students, either high school or college stu- dents with an interest in teaching. These aides were assigned to oversee the various activity centers of the rooms which left the regular teacher free to work with small groups or individuals and to coordinate the total room activity. Many are convinced that adult or older stu- dent aides are the ultimate solution for individualizing 72 education. However, a number of regular public school classrooms were also observed where teachers were carrying out the same kind of procedures by training even first and second graders to operate activity centers for themselves. Upon entering a second-grade room, on one recent visit, several clusters of desks were noticed at which small groups of children were independently busy at tasks they had helped to set for themselves. In one corner a "librar- ian" was checking books in and out. Two children were pinning up art work. One young man was on his way to the school office to handle some necessary records. Someone was caring for the turtle and the fish. There was complete freedom of movement, yet all were seriously at work with reasonable quiet. The teacher was conferring with only one person at a table. Her aides were her own students. And their efficiency was hard to believe. Yet, six months earlier they were just another typical second-grade class. This teacher had carefully and deliberately, step by step, taught her students at least one good way to perform each needed job and then let them practice doing it. When enough students had mastered a repertoire of basic skills at independent activity, she was then able to free herself to work more closely with those who needed special help. In such a classroom environment one cannot fail to be impressed by the high level of general achievement, the enthusiasm of the students toward their work, the high degree of self-control even with freedom of movement, and 73 the availability of individual attention as needed. Alter- ing the teaching approach from a predominance of telling to one of facilitation and coordination goes a long way toward making individualization possible. Two volumes are recommended as especially helpful in learning how to provide this type of instruction: Learniqg How To Learn: An American Approach to Montessori, by Nancy McCormick Rambusch, and Individualizing_Instruction, ASCD Yearbook, 1964. Summapy.--Programs developed for teaching percep- tually handicapped children how to learn effectively include: (1) residential school placement, (2) special day school placement, (3) special (segregated) class placement, (4) working with an itinerant teacher on a therapy-session basis, and (5) individualized instruction within the regu- lar classroom. All five programs basically seek to provide individualized instruction in terms of needs determined by comprehensive diagnosis. The methods and materials that are seen as most appropriate in any of the five programs, whether devised by teachers or commercially supplied, resemble those developed by Maria Montessori. Very few students actually need any type of special class placement. Special schools and departments of special education in public schools have grown out of sensible proportion due to a lack of recognition and/or provision for individual dif- ferences in regular classroom programs. It is recognized 74 that when children are segregated for any reason this in itself tends to stunt healthy mental development. The pri- mary aim of special classes is rehabilitation and success- ful coping with the "normal" world, and is in recognition of the fact that special classes are desirable only as emergency measures. Therefore, except for an extremely small number of severe cases, increased emphasis should be given to individualizing education in regular public school classroom situations and the earliest possible elimination of most special class placement. CHAPTER VI RECOMMENDATIONS FOR DEVELOPING NEW CURRICULA Organizing for action.--Nothing whets a good teacher's appetite more for learning about new approaches than hearing about positive results. The good teacher strongly identifies with the individuals in her charge and suffers acute frustration when any child is blocked in what she knows to be an innate desire to learn: . . . an inborn urge and drive to push our own develop- ment and self-realization to their limits [28]. Therefore, a crucial first step a school system needs to take in developing new curricula for perceptually handi- capped youngsters is to communicate with the total staff about: (1) the need for new ways of working with students with perceptual handicaps, and (2) the benefits that have been realized from certain new approaches. How this communication should proceed in a given school system will depend on a variety of local factors, but in any case it should be thorough, somewhat startling, and offer new hope for better release of student potential. Some schools have initiated this process by bringing in a specialist to speak and answer questions at a total staff meeting. Other schools have organized small groups of administrators and/or teachers to study together and 75 76 make visitations to various on-going programs, and then utilized these staff people in various ways to "spread the word." Still other systems have used combinations of these two means. An important by-product of some measure of local staff involvement in such activity is the increased acceptance of new ideas presented, perhaps because of obvious approval of the ideas by significant persons within the local system. The possibilities for effective communi- cation are many; however, not much success has yet been achieved in other than "live" confrontations with the people to be affected. Another crucial first step is to establish a coordi— 'pg£gr for the program development activities. This person may be elected or appointed--from the teaching staff, from the administrative staff, or an outside professional retained for this specific task. The important--vita1-- thing is that he have the real authoripy to represent the staff, to facilitate and coordinate their activities, and to influence needed changes in system policies, procedures, and financial support to allow staff-developed program hypotheses to be tested in operation. For helpful infor- mation about this crucial and often very difficult role, three basic volumes are recommended: Role of Supervisor and Curriculum Director in a Climate of Change [82], Research for Curriculum Improvement [81], and The Human Group [42], and a professional journal article, "Recipe for Revolution: Beloit's Nineteen Ingredients" [39]. 77 Taking inventory of what exists.--Once a staff has had its intellectual equilibrium disturbed by effective communication of problems and possibilities, and a coordi- nator is established, it is time to take stock of what there is to work with in the local context. For this inventory-taking activity the coordinator should facilitate the organization of a Pilot Committee which includes interested and hpgply motivated key members of both the teaching and administrative staff. The Pilot Committee should make a thorough and systematic study of: (1) previously established statements of general philosophy and specific program goals, (2) cur— rent practices and how these compare with stated objec- tives, (3) operating policies, (4) physical facilities, (5) fundamental limits and possibilities for financing the educational program, (6) related special resource people and facilities in the community or available from others, and (7) possibilities for released TIME for staff involve- ment. Inventory findings of the Pilot Committee should be distilled and simplified for communication to the staff-~as needed. 'Definingproblems and setting goals.——The defining of problems and the setting of goals must be in terms of fundamentals. It should be remembered that the child's needs are to be programmed, not his label, so that there 78 can be no "one method" [68]. The committee should direct its efforts toward the generation of basic program concepts that will promote exploration and discovery by teachers as well as students. Though the knowledge of the part played by perception and concept formation in the learning of children has greatly increased in the last decade, much remains to be done. The implications have yet to be translated into practice. It is here that the cooperation and collaboration of teachers is needed. Action research is imperative. . . . There is just too much for either professional psychologists or educationists to attempt. Action research is an educative process for both teachers and children. A child learns how to learn only by learning something. The selection of curricu— lum content as well as methods and materials must be explored by teachers. Administrators must shoulder the responsibility for the initiation and leadership in such projects [49]. It is absolutely necessary that the committee have an atmosphere to work in that is free from criticism, con- demnation, or derision, particularly at the beginning of any effort dedicated to the generation of new ideas. Ways must be found early in the creative process to maximize the production of quantities of new and fresh ideas-~something not likely to happen where the fear of condemnation is present. It is also important at beginning stages of the curriculum development process to concentrate on areas of agreement rather than extensive debating of the pros and cons of problems where no satisfactory solution is likely to be found at the time [39]. When idea generation begins to slow down a little in the Pilot Committee (or in any small study group), it is often helpful to enlarge the original group. One effective 79 way to do this is to bring consultants into the delibera- tions: New points of view often start the flow of ideas again. A consultant often functions as a "pump primer." Those who have been involved in the creation of new programs at other schools are particularly useful. Not only do they contribute the fruits of their own programs, but, also, when confronted with some of the problems at hand . . . they are often able--and trained--to make some very original contributions [39]. Some of the problems that must be dealt with will clearly present themselves in the process of taking inven- tory. Others will have to be precipitated into view by a thorough analysis of pymptomatic information collected. Some of the problems will be of strictly local import, but some will have implications for education—at-large and studies should be conducted in a manner that will allow public access to program results. Basic goals should be established in terms of aiming to achieve for students edu- cational experiences that are consistent with both individ- ual needs and a general philosophy of education that is adequate to the times. Until these two basic issues are met and resolved, a curriculum committee has no real sense of direction. Once they are tentatively resolved, these "ends-in-view" should be communicated to the entire staff-- for their acceptance, rejection, or revision. It is.essen- tial to work out a general concensus before beginning actual program design, because these aims and goals must serve as criteria for evaluating program hypotheses and operational results. 80 Comprehensive investigation of previous research.-— Designs for new curricula will have little integrity if they are only grounded in concensus agreements by members of a curriculum committee, or even by the total staff. There must be comprehensive investigation and interpreta— tion of previous research findings. We do not deny the impact of habit, custom and tradi- tion upon curriculum. These are significant forces affecting curricular decisions which every group must take into account. We wish to make clear, however, that we reject these as inadequate bases for curricu- lum planning. Rather we favor an approach which poses fundamental questions and which makes its choices deliberately in favor of those alternatives which are supported by evidence gathered [24]. Few school systems now have adequate lines of communication with sources of research information. But there should be a continuous and expanding flow of informa- tion into the school system from a wide variety of relevant sources (for a listing of sources related specifically to perceptual disorders, see Appendix VII). Important infor- mation may be from the fields of pscyhology, sociology, educational theory, child growth and development, neurol- ogy, and psychiatry. Some of it may be found in publica- tions by professional organizations concerning selection of and orientation of subject-matter content. In short, it may be information from any source which will help the staff take into account the total range of factors which may affect the success of the program. Curriculum workers will plan best: 81 . . . if they are acquainted with the culture and have expert knowledge in a special direction [97]. Saturday Review and Tips, as well as many profes- sional journals, offer information about important new books in several fields that can be drawn upon by curricu- lum makers. Starting a healthy (and vitalizing) flow of new information into a school system is usually just a matter of writing postcards to request placement on mailing lists. One source of information that is rapidly growing in scope and value is the U.S. Office of Education. This office is sponsoring a great deal of research and coordi- nating the communication of findings to the public. It is also administering a growing quantity of federal legisla- tion that can be utilized to authorize and support local research and program development. Information on the poli- cies and procedures, as well as the means of applying for grants under these acts, may be obtained from the Bureau of Educational Research of the U.S. Office of Education. Another rapidly developing resource for assistance in curriculum development is the State Department of Public Instruction. Under new federal provisions state depart- ments are adding to their consulting staffs—-especially in the area of curriculum and instruction. School systems may now obtain from most of these departments consulting assistance in designing curriculum research and/or qualify- ing for federal funds for project operation. 82 Of course, an investigation of previous research means that curriculum committees must read and ponder new information to decide what, if any, bearing it may have on the work at hand. And wherever possible the committee should seek to distill important information into general ,principles that can be used to assess present operations and develop program hypotheses to be tested in future operations. Synthesis of curriculum prpposals.--Once the cur- riculum study group (Pilot Committee) has clearly in mind: (1) a philosophical foundation to work from, (2) the reali- ties of local problems and possibilities, and (3) available research information; it is time to put together some new program hypotheses consistent with these three areas of understanding. Educators who plan programs will be, at best, creative sypthesizers, relying on knowledge (the facts of research and opinions of experts) available from all the various fields that might contribute to program improvement. As program hypotheses are put together, they should be written into a comprehensive program proposal. This is another stage at which enlarging the Pilot Committee can be most helpful. Before taking a completed plan to the whole faculty for action, there is great value in putting a first draft into their hands--perhaps even a second draft-—complete with the specific points on which a vote will even- tually be taken, the rationale, and the full background of the problem. As much feedback as possible should be 83 invited from the . . . [staff] . . . at this time. This may be the first time that many of the faculty have been exposed to the proposal in its entirety and many of their comments may be highly constructive. . . . Drafts may be given to individuals known for their perceptiveness, their strong feelings against the program, or their ability to expose hidden flaws. If this procedure is followed, the proposals may be strengthened, and other faculty members will be aware that their opinions had been sought . . . the committee will have had a greater Opportunity to have been exposed to and to have wrestled with almost every con- ceivable argument related to the program [39]. Putting prpposals into action.--Activating new cur- riculum proposals is best done as a Pilot Study. Like the cautious bather who gingerly dunks one toe in the water to see if conditions are suitable for more complete immersion, the Pilot Study makes a smaller tentative commitment to action to assess the probabilities for successful opera- tions on a larger scale. It implies the expectation of adjustments and ondthe-spot revisions as feedback informa- tion points up the need. Cooperating teachers are able to be less anxious about how the new program will affect their classrooms because they know they can influence construc- tive changes in procedure. They don't have to feel that they have been handed a commitment too large or too set to resist or even reject when the evidence says it is going wrong. And they can feel that the door is open for contri- butions of creative ideas which will improve on original design. The classrooms chosen to participate in the Pilot Study should be those wherein the teachers are most 84 interested and willing to cooperate. And the teachers selected should be capable of varying their approaches to teaching so that the proposed methods may be given a fair chance to succeed. Evaluating program results.--Professional literature abounds with indictments upon curriculum makers for failing to evaluate programs properly. Few schools make a thorough analysis of how newly instituted methods and materials are affecting students--or even if the methods and materials are being used as intended. Once a program design is com- mitted to writing and published for distribution as a "guide," the curriculum committee more often than not folds its tents and returns to other "business as usual." It seems that it is one thing to plan well for change and quite another to carry it out. [But] . . . the art of teaching becomes identical with the science of education when a teacher attempts to predict the impact of his behavior on learners, and to test the accuracy of his prediction [81]. The difficulty abides in a certain human character trait. A person's conscious sphere is limited. One must relegate some of his thought processes to his subconscious mind. He devises a fix on a pattern of behavior and sub- merges it, letting it operate a certain function almost automatically--much like putting the instructions on mag— netic recording tape. And he will try to use these recorded instructions (habits) for behavior wherever and whenever they seem to fit the circumstances. If the 85 circumstances become radically different (as in an experi— mental situation) and "programmed behavior" is ineffective, a person will ordinarily persevere in trying to apply this behavior anyway, because to meet new circumstances ade— quately would mean removing a "program" and constructing a new one to take its place. This process involves a great deal of intellectual work which most people would usually prefer to put off until tomorrow. Attempts at change in a system inevitably evoke resistance to change. It is as if the larger system were defending itself, trying to maintain the previous equilibrium of role expectancies and role behaviors [81]. Good evaluation, then, will include checking from the beginning of operations to see if proposals are being tried out or resisted. If they are being resisted, the Pilot Study Committee should concern itself with analyzing the situation to discover the underlying forces that evoke resistance. Analysis often reveals the source of resistances and helps distinguish fundamental from superficial ones. Once barriers have been reduced or removed, existing positive motivation may bring about substantial, rela- tively tension-free change [81]. Pre-testing and post-testing with appropriate instruments that can yield data for statistical analysis is an important kind of evaluation. Some of the results of innovations may thus be interpreted and made available to others who would design new programs. There is a great need, if not a professional responsibility, to contribute to a general pool of research information—-to help advance 86 the level of awareness in the field. But this approach must be seen as only part of good evaluation, not the whole of it. It has been our painfully achieved conclusion that if evaluation is to be of help it must be carried out to provide feedback at a time and in a form that can be useful in the design of materials and exercises. . . . The essence of evaluation is that it permits a general shaping of the materials and methods of instruction in a fashion that meets the needs of the student, the cri- teria of the scholar from whose discipline materials . have been derived, and the needs of the teacher who seeks to stimulate certain ways of thought in his or her pupils. . . . Evaluation is often viewed as a test of effectiveness or ineffectiveness—-of materials, teaching methods, or whatnot-—but this is the least important aspect of it. The most important is to pro- vide intelligence on how to improve things [14]. Needed educational research.--An analysis of what is presently known about the education of children with per- ceptual handicaps indicates that validated information is lacking in several important problem-areas. There is great need for public school systems to make these problem-areas the focus of research projects that can aid in the develop- ment of local curricula and contribute to a general pool of information for all educators to draw upon. Studies should be established to analyze the funda- mental reasons that learning is facilitated py the use of certain materials. It would be immensely helpful to know what underlying principles operate to enable a child to utilize certain materials to learn in spite of a perceptual handicap. If correlations could be established between operational principles brought into play by certain 87 materials and specific types of perceptual handicaps, it would be possible to be more accurate in prescribing appro- priate educational experiences once the type of perceptual disorder is diagnosed. Studies are needed to determine the incidence of children with perceptual disorders at the various age levels. The theory that most perceptual disorders are developmental and not pathological in nature needs addi— tional supporting evidence to be considered valid. Also, when it is possible to establish more conclusive evidence of the extent of perceptual problems, it will be easier to motivate school boards and legislatures to provide the services needed for these children. Research is needed to determine the incidence qf emotionalpproblems, at various age levels, that are pri- marily due to unattended or mistreated perceptual dis- orders. If evidence could be established concerning the amount of time that perceptual disorders can exist unattended or mistreated before this results in the onset of serious emotional disorders, curriculum planning com— mittees could be greatly facilitated in establishing pri- orities'for action. The effects on classroom behavior by treatment with various drpgs needs to be evaluated. School systems cannot administer and measure the effects of drugs, but they can cooperate with physicians by making systematic observations of changes in classroom behavior induced by the drugs 88 prescribed by physicians. An extremely hyperactive child, for instance, has limited or no control over this way of responding to his environment. A certain drug might inter- vene in the functioning of the central nervous system and make it possible for him to gain control, thus being freed to pay attention to learning. As of this date there is little objective evidence of the effects of drug therapy on classroom behavior. What evidence there is points to remarkable potential, just as insulin has made it possible for diabetics to lead more normal and productive lives. Research is needed to determine the fundamentals of instructional methods that are successful in helping_per- ceptuallyphandicapped children "learn how to learn." At this point in time many different and some seemingly opposed methods seem to work a good deal of the time. It would be helpful to have these "successful" innovations analyzed to find out what are the common basic reasons for their productive influence. The methods of Montessori, Frostig, Delacato, Kephart, Lehtinen, Strauss, and Lukens, for instance, should be comparatively analyzed to see what fundamentals they touch on in common. From this identifi- cation of the basic contribution each successful method makes to improved learning in spite of a perceptual dis- order, it would probably be possible to devise even better and more economical teaching methods. Validation of the meaning of profiles (patterns) of scores obtained on 1.0. sub-tests is needed. If the 89 attainment of certain profiles of sub-test scores could be correlated with the presence of certain types of perceptual disorders, it would give teachers something to go on even while waiting for the results of more comprehensive diagnosis. Advance knowledge of the profile derived for a child and its validated general implications would greatly assist the medical examiner in pinpointing the etiology of the child's perceptual disorder(s). Summary.—-An important first step in initiating the development of new curricula is the creation of a small crisis by stimulating, even startling, a school staff with strongly supported evidence that they have a mutual problem which, unsolved, is having serious consequences for chil- dren in their charge. Guest experts or key staff members who have made a special study can easily perform this7 service. When a staff is "sufficiently stirred up," a coordinator should be established to facilitate productive action toward the development of new curricula. It is not necessary to have all the staff at work at any one time on developing curriculum proposals, but all need to be involved in some way at least some of the time--if only to offer critical appraisals. Establishing a Pilot Committee of highly motivated staff and administrators is a good way to begin the actual process of curriculum development. Research and synthesis most accurately describe the legiti- mate business of a curriculum committee. They must do 90 research to discover what elements there are to work with that relate to the problem at hand and synthesize new approaches for dealing with it. At various points along the way, outside visitations, guest lecturers, and working with consultants can help "keep up a full head of steam." Also at various points along the way the total staff should be informed--in open forums-~of progress being made. It is important that there be general concensus on basic aims and goals which will serve as criteria for evaluating proposals and program results. The best program proposals can be developed by an approach in which fundamental questions are posed and choices are deliberately made in favor of alter- natives supported by evidence from a wide variety of perti- nent sources. Among important emerging curriculum resources are the U.S. Office of Education and the State Departments of Public Instruction. They now give assist- ance in designing curriculum research and qualifying for financial aid from the federal government to support new programs. Once program proposals are clearly worked out and understood by the total staff, a Pilot Study operation is the best way to put these concepts into action. Since a Pilot Study is small enough to observe closely, errors can be corrected and improvements made before full-scale opera- tions are begun. Provisions should be made for continuous feedback of program effects--starting with the first day of operations. Despite every effort to smooth the way, impending change inevitably evokes resistance. Teachers, 91 being human creatures of habit, will most often tend to continue old modes of operation—-even after contributing to and showing high interest in the new design. Cooperating teachers for the Pilot Study should be chosen on the basis of interest, competence, and flexibility so that they are willing and able to find ways to give the new proposals a fair test. But the Pilot Committee will also need to devise ways to help cooperating teachers analyze their per— formance as compared to aims agreed upon. The usual objec- tive pre-testing and post-testing and analysis of results are important for the local school system and the possible contributions they may make to knowledge in the field, but by far the most value is obtained from evaluation efforts by providing intelligence that permits a general improve— ment of methods and materials of on-going instruction, especially in terms of the individual student. Education is on the threshold of a new era wherein it will be almost impossible not to have increased concern for perceptually handicapped learners. But much new programming and vastly increased public school research are needed if anything significant is to be done for this group that comprises nearly a quarter of the children of elementary school age. In reading and listening to the current dialogue on malfunctioning of perceptual processes and the impli- cation it has for the learning process, one cannot help but be aware at times of an intriguing naivete that reflects the innocent as he surveys a still virgin field. Though the first flush of the "discovery of perception" as a problem area with the exceptional has somewhat abated, the problem of comprehension and uti- lization in terms of the pragmatics of the child who 92 has["p§rceptua1 difficulties" is still very much with us 99 . Perhaps, for a first step forward, it will help if we make it a point to see these children not as having learning disabilities, but as having differentially based learning problems-aproblems that can be solved. In any case, now that it is known that proper assistance can be given to free a human personality who is otherwise doomed to endure gradual destruction, a fundamental question is posed: can it be anything short of willful negligence to fail to try to devise ways to give the needed help? APPENDIX I CHARACTERISTIC BEHAVIORAL SYMPTOMS [31] A. The child may evidence disturbances in perceptual motor functioning: He may Show reversals in reading and/or writing. He may Show difficulties in left to right orientation. He may Show difficulty in eye—hand coordination. He may have figure—ground problemS--selecting out a particular word from a page (for example), or separat— ing foreground from background. He may have problems with form constancy—-where he can recognize "a" in printing, but not in script, or "a" in a book, but not on the blackboard. He may show difficulty in form discrimination-—being unable to tell a circle from a square, or an "a" from an "e". If the child has problems with the rotation of forms-- we would see much frustration with trying to differen- tiate "b" and "d", "s" and "z", "p" and "q". He may have a very poor sense of spatial relations-- poor judgment of distance and size of things in space. He may be a very poor reader, but good in other subjects. 93 94 B. The child may have difficulty in concept formation: 1. 2. 5. C. He 1. His ability to think things out, to reason, may be diminished. He has no basic comprehension of what he reads. He is unable to summarize or give you the main theme of what he has read, even though he can read it. He cannot follow directions. Demonstrates an inability to generalize, that affects his dealing with new situations. Would Show problems in grasping knowledge of quanti- ties, months of the year, putting the same kinds of things together, how things may be alike, etc. may show language difficulty: Developmentally his speech may be at a more immature level than would be expected of a child of his chronological age. His general language development may show a develop- mental lag. May evidence a particular difficulty expressing him— self-~finding the right word, fluency of Speech. His auditory discrimination may be poor, therefore his ability to discriminate what is being said to him. D. There may be problems in behavior: 1. He may evidence a great deal of hyperactivity--moving about constantly, or even when seated, constantly in motion. He may be a discipline problem in the classroom. His 95 lack of impulse control may lead him into a great deal of difficulty because he does not have the inhibiting mechanism that other children have, and acts upon most impulses immediately. He cannot resist touching objects or people. If angered, may strike out without "thinking." This lack of impulse control would also evidence itself in situations where a delayed response is necessary and this child cannot restrain himself and acts or Speaks out of turn. He may overreact to emotional stimulation and Show catastrophic reactions to the most minor situations.‘ He may seem to be unable to focus on what is being taught, but is paying attention to many things at once, giving nothing his full attention. He Shows a Short attention span. He is highly distractible and very small things will pull his attention away from what he is supposed to be doing. His efficiency and command of skills varies from day to day--yesterday he knew his multiplication tables perfectly, but today can't remember a thing. His lack of success in the past often creates prob- lems before a task is begun; he is frustrated and angry, and may Show very poor school attitudes. A. B. APPENDIX II PRELIMINARY "SIGNS AND SYMPTOMS" CATEGORIES [20] TEST PERFORMANCE INDICATORS 1. Spotty or patchy intellectual deficits. Achievement low in some areas; high in others. Two years below on drawing tests (man, house, etc.) when compared with mental age on standardized intel— ligence tests. Geometric figure drawings poor for age and intelligence. Poor performance on block design and marble board tests. Very poor showing on group tests (intelligence and achievement) and daily classroom exams which require reading. Characteristic patterns on the Wechsler Intelligence Scale for Children, including "scatter," high verbal- low performance, low verbal-high performance. PERCEPTUAL--CONCEPTUALIZATION DISTURBANCES l. 2. 3. 4. Impaired tactile discrimination. Size discrimination impaired. Impaired right-left and up—down discriminations. Poor spatial orientation. 96 5. 6. 7. 8. 9. 10. 11. 97 Time orientation impaired. Distorted concept of body image. Impaired judgment of distance. Poor figure—ground discrimination. Impaired part-whole discrimination. Frequent perceptual reversals in reading and in writing letters and numbers. Poor perceptual integration. Child cannot fuse sensory impressions into meaningful entities. C. SPECIFIC NEUROLOGIC FINDINGS 8. 9. 10. 11. Few, if any, "gross" abnormalities found. Many "soft," equivalent, or borderline findings. Reflex assymetry. Mild visual and/or hearing impairments. Strabismus. Nystagmus. High incidence of left, mixed, and/or confused laterality. Hyperkinesis. Hypokinesis. General awkwardness. Poor fine visual-motor coordination. D. DISORDERS OF SPEECH AND COMMUNICATION 1. 2. 3. 4. Impaired auditory discrimination. Inclusion of all the aphasias. Prevalence of slow language development. Mild hearing loss. F. G. 5. 98 Frequent mild speech irregularities. DISORDERS OF MOTOR FUNCTION 1. 7. Athetoid, Choreiform, tremor, or rigidity of hand movements. Frequency of tics and grimaces. Late in learning to walk. General awkwardness or clumsiness. Poor fine and/or gross visual-motor coordination. Hyperactivity. Hypoactivity. ACADEMIC ACHIEVEMENT AND ADJUSTMENT 1. 2. 3. 4. 5. 6. 7. 8. 9. Reading disabilities. Arithmetic disabilities. Spelling disabilities. Poor printing, writing, and/or drawing ability. Variability in performance from day to day. Poor organization of work. Slow to finish work. Frequently does not understand instructions. Frequently does well on verbal tasks. DISORDERS OF THINKING PROCESSES Poor abstract reasoning ability. Thinking is concrete. Conceptualization difficulties. Disorganized thinking. Poor memory. Autistic. I. J. 7. 99 Thought perseveration. PHYSICAL CHARACTERISTICS 1. 2. 3. Excessive drooling as young child. Excessive sweating. Prevalence of thumb-sucking, nail-biting, head— banging, teeth-grinding. Frequently has peculiar food habits. Slow to toilet train. Easy fatigability. Frequent enuresis. Encopresis. IMPULSE CONTROL 1. 2. 3. 4. 5. 6. 7. 8. Tend to be very impulsive. Explosive. Low stimulus threshold. Poor emotional and impulse control. Low frustration tolerance. Reckless. Disinhibition. Act before they think, then sorry. SLEEP CHARACTERISTICS 1. 3. 4. Frequent rocking and head-banging before falling into sleep. Irregular sleep patterns as young child. Frequent night terrors. Early resistance to naps and early bedtime. Excessive movement during sleep. 100 6. Light Sleepers. 7. Deep Sleepers. K. RELATIONSHIP CAPACITIES 1. Poor peer group relations. 2. Fleeting attachments of self-interest of the moment. 3. Easy acceptance of others alternating with withdrawal and shyness. 4. Poor judgment in social and interpersonal situations. 5. Socially bold and aggressive. 6. Inappropriate, unselective, and often excessive displays of affection. 7. Desire to touch, cling, and hold on to others. L. PHYSICAL DEVELOPMENT 1. Frequent lags in development, e.g., motor, language, etc. 2. Physically immature. 3. Physically advanced for age. M. "ANTI-SOCIAL" BEHAVIOR 1. Aggressive. 2. Negative to authority. 3. Rough, cruel, defiant. 4. Unmanageable. 5. Social competence subnormal for age and measured intelligence. 6. Unpredictable. 7. Lying. 8. Stealing. 101 9. Sex misbehavior. 10. Sociopathic behavior. N. "PERSONALITY" CHARACTERISTICS 1. Easily led; gullible. 2. Variable from day to day. 3. Moody. 4. Frequently sullen and seclusive. 5. Timid. 6. Phobic. 7. Fearless. 8. Very sensitive. 9. Remorseful. 10. Demands own way; frequent rage and tantrums when crossed. 11. Poor adjustment to environmental changes. 12. Sweet and even tempered. l3. Friendly and outgoing. l4. Talkative and eager to please. 0. DISORDERS OF ATTENTION AND CONCENTRATION 1. Short attention span for age. 2. Distractible for age. 3. Impaired concentration ability. 4..Inattentive. 5. Perseveration. 6. Impaired decision-making ability, particularly when given too many choices. 102 Several authors note that many of the characteris- tics improve with the maturation of the central nervous system. Variability beyond that expected for age and measured intelligence appears as a common denominator throughout most of the signs and symptoms. This, of course, limits predictability and expands misunderstanding of the child by his parents, peers, teachers, and often the clinicians who work with him. A frequency distribution of the signs and symptoms resulted in the following listing of the ten most often cited by the various authors, in order: 1. Hyperactivity. 2. Perceptual-motor impairments. 3. Emotional lability. 4. General coordination deficits. 5. Short attention span. 6. Impulsivity. 7. Distractibility. 8..Specific learning disabilities: a. Reading. b. Arithmetic. c. Writing. d. Spelling. 9. Language disorders. 10. Equivocal neurological Signs and E.E.G. irregulari- ties. 103 The "Sign" approach can serve only as a guideline for identification and diagnosis. The protean nature of the disabilipy is the obvious conclusion which can be drawn from the approach to Symptom- atology and identification taken above. The situation, however, is not as hopeless as it might appear. Order is somewhat salvaged by the fact that certain symptoms do tend to cluster to form recognizable clinical entities. This is particularly true of the "hyperkinetic syndrome," within the broader context of minimal brain dysfunctioning. The "hypokinetic syndrome," primary reading retardation, and to some extent the aphasias, are other such examples. If these disorders could be established as Specific diagnostic categories within the minimal brain dysfunction classification, the total problem might well be on its way to solution. This is seen as a relatively easy task and seems a logical starting point. l. 2. 3. 5. APPENDIX III STEPS IN ADEQUATE DIAGNOSIS Make systematic observations of any child who exhibits Iearning probIems. Make systematic records of observations, noting what Specific behavior occurred and how muEH of it. A cate- gorized check-list is helpful. Meet with parents to: 3.1 discuss observed behaviors, 3.2 obtain developmental background information, 3.3 gain concurrence for comprehensive psychometric e SEIng, 3.4 arrange for a thorough medical examination. Obtain a multi-disciplinary evaluation of all informa- tion gathered: teacher observations, deveIopmentaI background, psychometric evidence, and medical evidence. Preferably the evaluation should be done in a learning disabilities diagnostic clinic, but in the absence of such a facility a multi-disciplinary evaluation team can be organized from appropriate members of the school staff and local professional personnel. Use the comprehensive diagnosis information to plan edu- catibnaI experiences for individuaIs‘In terms of their specific learning needs. 104 1. 2. APPENDIX IV SIX TYPES or INTRACLASS GROUPING [72] (An Adapted Listing) Interest grouping.--Children who are interested in a particuIar topic such as "butterflies" in science will pool the information they have gained from reading different science books and other materials. Special needs grouping.--Certain children from other reading groups may be called together to form a special group for learning a particular technique they need, such as help with vowel sounds in phonetic analysis of words. Team_gropping.--Here two children are working together as a team on a Specific problem common to both. Tutorial gropping.—-This refers to a group formed for direct instruction by the teacher or sometimes by a more advanced child who needs help from the teacher in plan- ning what he will do with the small group which he is leading. Research grouping.--This is a useful device when two or more children work together on a particular topic to prepare a report for the class or other rooms in the school. Full class grouping.--There are a number of activities which are’BesE introduced to a total class in the sense that they are common or core learnings. For example, no matter what the different reading levels of a fourth grade may be, all of the children will need some help in learning how to use a dictionary effectively. 105 APPENDIX V COMMERCIAL SOURCES FOR PERCEPTUAL DEVELOPMENT MATERIALS [69] AMERICAN BOOK COMPANY 300 Pike Street Cincinnati 2, Ohio AMERICAN PRINTING HOUSE FOR THE BLIND 1839 Frankfort Avenue Louisville 6, Kentucky BECKLEY-CARDY COMPANY 1900 W. Narragansett Avenue Chicago 39, Illinois BENTON REVIEW PUBLISHING COMPANY Fowler, Indiana CADILLAC PLASTIC AND CHEMICAL COMPANY 1511 Second Avenue Detroit 3, Michigan CHRONICLE GUIDANCE PUBLICA- TIONS, INC. Moravia, New York CONTINENTAL PRESS Elizabethtown, Pennsylvania CONSULTANTS PSYCHOLOGISTS PRESS 577 College Avenue Palo Alto, California EDUCATORS PUBLISHING SERVICE 301 Vassar Cambridge, Massachusetts Upton Arithmetic Workshop Books 1, 2, and 3 Touch and Tell Volumes 1 and 2 Chart Printer Print-Scrip Sentence Builder Phonic Sounds We Use Books 1, 2, and 3 1/4" x 9-3/8" x 9-3/8" clear Plexiglas for patterns Sounds I Say Activities Books 1 and 2 Teacher's Manual Practice Exercise in Arithmetic Books 1, 2, 3, and 4 Teacher's Manual Dittoed Material (Indepen— dent Activities, Rhyming, etc.) Frostig Tests Testing Materials. 107 THE ECONOMY COMPANY 529 W. Capital Avenue Indianapolis, Indiana FOLLETT PUBLISHING COMPANY 1010 W. Washington Boulevard Chicago, Illinois GENERAL PRINTING COMPANY 17 W. Lawrence Street Pontiac, Michigan E. M. HALE PUBLISHING COMPANY 1201 5. Hastings Way Eau Claire, Wisconsin HALSAM PRODUCTS COMPANY Dept. "N" 3610 Touhy Avenue Chicago 45, Illinois HARCOURT, BRACE AND WORLD 7555 Caldwell Avenue Chicago, Illinois HARPER AND ROW PUBLISHERS 2500 Crawford Evanston, Illinois HARR WAGNER PUBLISHING COMPANY 609 Mission Street San Francisco, California HOUGHTON MIFFLIN COMPANY 2 Park Street Boston 7, Massachusetts L. N. SALES COMPANY 12345 Woodward Avenue Detroit 3, Michigan Phonetic Keys to Reading Series Teacher's Manuals Frostig Material Teacher's Manuals Magic Markers Scissors Stamp Pads Ebony Pencils 15" Rulers, Metal Edges General Supplies Getting Ready to Read Morrison and Seymour-- Mother Hubbard First Steps in Reading-- Books 1, 2, and 3 Changeable Blocks Dominoes Checkers Anagrams Halsam Puzzles Testing Materials Gesell Development Kit which includes Tests and Recording Sheets Deep Sea Adventure Series Jim Forest Series Experimenting with Numbers Teacher's Manual Discovering Arithmetic-- Books 1 and 2 Pupil's Workbooks and Teacher's Manual Harrison Stroud Reading Readiness Profiles Child Guidance Toys 108 LYONS AND CARNAHAN 2400 Prairie Avenue Chicago 16, Illinois McCORMICK—MATHERS PUBLISHING COMPANY Columbus, Ohio McGRAW HILL BOOK COMPANY 1154 Reco Avenue St. Louis, Missouri 63126 CHARLES E. MERRILL BOOKS, INC. 1300 Alum Creek Drive Columbus 16, Ohio MICHIGAN PRODUCTS, INC. 1236 Turner Street Lansing, Michigan MICHIGAN SCHOOL SERVICE 312 N. Grand Avenue Lansing 2, Michigan Phonics We Use Books A, B, C, and D Puzzle Books-—Books l, 2, and 3 Phonic Books-~Speed Boat, Jet Plane, Rocket, Space Ship, Stream Liner, AtOmic Submarine Programmed Reading Material Nicky--Grade 2 Uncle Funny Bunny--Grade 3 Tom Trot-~Grade 5 Scottie--Grade 3 Adventure TrailS-—Grade 4 Playskool Toys Colored Plastic Beads Folding Perception Cards Gummed 1" White Circles Number Grouping Disks Stencils--Combination Sets Colored Tablets Sewing Cards Beaded Pegs Colored Pegs Peg Board Parquetry Design Blocks Economo Sentence Builder Pupil's Seatwork Chart Flocked Sheets (for flannel board) Co-ordination Board Colored Gummed Paper Construction Paper Sequence Pictures for Peg Board Magic Cards (Classification opposites sequence) Magic Cards--Consonants Magic Cards-~Blends and Digraphs Magic Cards--Vowels End-in—E-Game Quiet Pal Game Peg-Flannel Board NOVO EDUCATION TOY AND EQUIPMENT COMPANY 585 Avenue of the Americas New York 11, New York OPEN COURT PUBLISHING COMPANY P. O. 7983 Chicago, Illinois PACKARD VISUAL SUPPLIES Portage, Wisconsin SCHOOL MATERIAL COMPANY 1801 S. Michigan Avenue Chicago 18, Illinois SCOTT, FORESMAN PUBLISHING COMPANY 433 E. Erie Street Chicago 11, Illinois TEACHING RESOURCES, INC. 334 Boylston Boston, Massachusetts WEBSTER PUBLISHING COMPANY 1808 Washington Avenue St. Louis, Missouri WINTER HAVEN LIONS CLUB P. O. Box 1045 Winter Haven, Florida WORLD BOOK COMPANY 2126 Prairie Avenue Chicago 16, Illinois WORLD WIDE GAMES Delaware, Ohio Judy See-Quees Workbooks NDEA Kit My Surprise Book English Material The New Way We Read-- Gray, Artley, Steel Visual Motor Perception Teaching Materials On the Way to Reading-- Workbook Second Grade Reading Seatwork Eye and Ear Fun--Books l, 2, 3, and 4 Basic Goals in Reading (Paper Back Workbooks) to 3rd Grade Pre-Primer Seatwork, Althea Beery Primer Seatwork County 5--Adventure with Numbers First Reader Seatwork Seatwork Activities (Stone) Geometric Form Templets and Manual I Work By Myself--Clark and Elsbree Puzzles Games APPENDIX VI TEACHER DEVELOPED CONCEPTS FOR DEVISING MATERIALS [77] (An Adapted Listing) 1. Multi-sensory learning experiences: 1.1 Audio, visual, and kinesthetic approach to phonics. 1.2 Auditory perceptual development-~tape recorder, musical instruments. 1.3 Textured letters for tactile reinforcement. 1.4 Tracing. 1.5 Color cueing. 1.6 Enlarging. 1.7 Find many ways to do the same thing. Manipulative materials to sustain attention and induce opersonal organization: 2.1 Self-teaching devices. 2.2 Dot-to-dot puzzles for parts to whole and figure— ground problems. 2.3 Abacus with transfer of perceptual patterns of quantity. Cut down extraneous stimuli--focus on the thing to be Iearned: 3.1 Portable screens to separate easily distracted children for work. 3.2 Slotted paper for markers. 3.3 Work with single pages of workbook material (removed from workbook) with cueing techniques. 3.4 Cut up workbooks to provide lessons in small steps. 110 APPENDIX VII ASSOCIATIONS FOR THE HELP OF CHILDREN WITH ALABAMA: ARKANSAS: ARIZONA: CALIFORNIA: COLORADO: CONNECTICUT: LEARNING DISABILITIES [5] ALABAMA FOUNDATION TO AID APHASEID CHILDREN 3261 Mockingbird Lane Birmingham, Alabama ARKANSAS ASSOCIATION FOR CHILDREN WITH LEARNING DISABILITIES P. O. Box 160 England, Arkansas CHILD STUDY AND CONSULTATION 1141 E. Rose Lane Phoenix, Arizona CALIFORNIA ASSOCIATION FOR NEUROLOGICALLY HANDICAPPED CHILDREN P. O. Box 604 Main Office Los Angeles, California LEARNING AND BEHAVIOR ASSOCIATED CLINICS California State College at Los Angeles Los Angeles, California HARBOR COUNCIL FOR NEUROLOGICALLY HANDI- CAPPED CHILDREN 11291 McNab Street Garden Grove, California COLORADO ASSOCIATION FOR CHILDREN WITH LEARNING DISABILITIES 11800 W. 29th Place Denver, Colorado ASSOCIATION FOR PERCEPTUALLY HANDICAPPED CHILDREN 699 Matianuck Avenue Windser, Connecticut CONNECTICUT ASSOCIATION FOR BRAIN INJURED CHILDREN P. O. Box 463 Norwalk, Connecticut 111 ILLINOIS: INDIANA: KENTUCKY: MARYLAND: MASSACHUSETTS: MICHIGAN: MINNESOTA: MISSOURI: 112 FUND FOR PERCEPTUALLY HANDICAPPED CHILDREN LEARN--Box 656 Evanston, Illinois WEST SUBURBAN ASSOCIATION FOR THE OTHER CHILD 354 Prospect Avenue Glen Ellyn, Illinois CHICAGO ASSOCIATION FOR CHILDREN WITH LEARNING DISABILITIES 8820 S. Washtenaw Chicago, Illinois INDIANA ASSOCIATION FOR BRAIN INJURED CHILDREN 225 N. Cornell Circle Fort Wayne, Indiana KENTUCKY ASSOCIATION FOR CHILDREN WITH LEARNING DISABILITIES c/o I. Stuart Smith 102 Stivers Road Louisville, Kentucky JEFFERSON COUNTY PARENTS OF PERCEPTUALLY HANDICAPPED CHILDREN c/o William Ryan« 3930 Grandview Louisville 7, Kentucky MARYLAND ASSOCIATION FOR BRAIN INJURED CHILDREN 4802 Nurton Avenue Baltimore, Maryland 21215 PERCEPTUAL EDUCATION RESEARCH CENTER P. O. Box 84 Sherborn, Massachusetts DETROIT CHILDREN'S NEUROLOGICAL DEVELOPMENT PROGRAM 224 Fischer Road Grosse Point 30, Michigan MINNESOTA ASSOCIATION FOR CHILDREN WITH LEARNING DISABILITIES Box 6391 Minneapolis 23, Minnesota Mrs. Yates Trotter 910 E. University Springfield, Missouri MONTANA: NEW JERSEY: NEW YORK: OKLAHOMA: ONTARIO: PENNSYLVANIA: RHODE ISLAND: TENNESSEE: TEXAS: 113 MONTANA CENTER FOR CEREBRAL PALSY AND HANDICAPPED CHILDREN 1500 N. 30 Street Billings, Montana NEW JERSEY ASSOCIATION FOR BRAIN INJURED CHILDREN 61 Lincoln Street East Orange, New Jersey NEW YORK ASSOCIATION FOR BRAIN INJURED CHILDREN 305 Broadway New York 7, New York OKLAHOMA COUNCIL FOR CHILDREN WITH LEARNING DISABILITIES 3739 S. Delaware Place Tulsa, Oklahoma ONTARIO ASSOCIATION FOR CHILDREN WITH LEARNING DISABILITIES 306 Warren Road Toronto 7, Ontario, Canada PENNSYLVANIA ASSOCIATION FOR BRAIN INJURED CHILDREN 343 Locust Street Coopersburg, Pennsylvania 20 Elder Avenue Riverside, Rhode Island MEMPHIS EDUCATION FOUNDATION Box 17034 Memphis, Tennessee TEXAS COUNCIL FOR CHILDREN WITH LANGUAGE DISORDERS 4827 Chedder San Antonio, Texas HOUSTON COUNCIL FOR CHILDREN WITH MINIMAL BRAIN DAMAGE 5674 Edith Street Houston, Texas PROVIDENCE SCHOOL 900 College Avenue Fort Worth, Texas VERMONT: VIRGINIA: WISCONSIN: 114 CHILD DEVELOPMENT CLINIC University of Texas Medical Branch Galveston, Texas TEXAS ASSOCIATION FOR CHILDREN WITH LEARNING DISABILITIES 1532 Avenue B Beaumont, Texas ASSOCIATION FOR THE MINIMALLY BRAIN DAMAGED 6214 Woodland Drive Dallas 25, Texas 79 Lincoln Avenue Rutland, Vermont 2930 N. Oxford Street Arlington 7, Virginia MILWAUKEE SOCIETY FOR BRAIN INJURED CHILDREN 6125 W. 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