handicapped by a severe hearing loss. By lowering the age at which children with hearing loss are detected and services offered, we are automatically increasing the demand for properly trained teachers. Furthermore, the research undertaken in the last few years has provided us with better tools for identification of children with handicaps, and this has also contributed to the ability to diagnose children at various ages, thus increasing the number of such youngsters being brought into special education programs and providing increased pressure for additional highly trained teachers.

Another cause for increased pressure has been that created by the German measles (rubella) epidemic of 1964-65 which has substantially increased the number of hearing impaired children and, even more importantly, increased the number of multiple handicapped deaf children who are now entering our educational programs. The impact of an attack of German measles on a mother during her first three months of pregnancy has proven to be disastrous for many of the offspring of these pregnancies, and this has called for a teaching profession with additional skills even beyond those normally required of a teacher of deaf children. Predictions of more than 20,000 youngsters resulting from the rubella epidemic have been made. Even if this figure is off by a factor of 50% the impact upon educational programs and the need for teachers will be profound.

There are still many teachers in our educational programs for deaf children who have not the proper qualifications and training. Such teachers, though dedicated and willing, in many instances have earned few if any course credits in the education of the deaf at an accredited university. The growth of day programs in the public schools, a highly desirable trend from the standpoint of the families since it is directed toward the ultimate integration of these deaf children in a hearing society, has been undertaken many times without the availability of properly trained teachers. Such programs, therefore, have not always been successful nor can they be until there is a sufficient number of qualified teachers to undertake the educational programs at this level. With estimates of something in the order of 600 to 700 new teachers of the deaf required each year to meet classroom needs under the traditional settings common just 10 years ago, it is evident that the proliferation of the day classrooms in regular schools will increase this number by a substantial percentage.

The increase in the number of day programs for hearing impaired children, as compared to residential programs traditionally carried out in large state institutions, has placed a tremendous pressure upon the needs for proper supervision. All too frequently today the teachers in these day class situations find themselves reporting to supervisors who are not familiar with the needs of hearing impaired children and are unable to provide the guidance and support which a young teacher has the right to expect from her superiors. At the National Research Conference on Day Programs for Hearing Impaired Children, run concurrently by Teachers College, Columbia University and the Alexander Graham Bell Association for the Deaf, May 10-13, 1967, with the support of the U.S. Office of Education, the participants emphasized the desperate need for developing standards for supervision of day class programs and the training of individuals to fulfill these positions of responsibility. A preliminary report of this conference in pamphlet form is attached to serve as a part of the record because it touches very strongly upon the need for proper supervision of classroom teachers as well as the need for the development of teacher certification standards and a professional organization of educators of the hearing impaired, which can serve to develop leadership, improve standards in educational training, and generally upgrade the teaching profession. I am most pleased to report that a new section of the Alexander Graham Bell Association for the Deaf has been initiated in response to the request of teachers, primarily those in the public school day programs, to carry out the objectives and meet the needs as expressed in the National Research Conference at Lake Mohonk.

It is for the reasons outlined above that we are pleased to support this legislation which will extend the program for training teachers of the deaf and the hearing impaired, as well as researchers, for another three-year period. It is difficult for us to see how these needs will be met were this program not to be continued and expanded in the coming years.

Facilities

By continuing and expanding the legislation for the construction of both university-affiliated and community facilities for the mentally handicapped. we can be assured of assistance both for the deaf child with complications of mental retardation and for those with other neurological handicapping conditions. Fur

thermore, the additional support for staffing of the university and community mental retardation facilities assures that professional and technical personnel can be trained and engaged to help in the initial periods of growth of these programs till they are on their feet and properly organized. The rubella epidemic, mentioned earlier, is known to have implications far greater than just hearing loss for many of the children whose mothers were touched by this disease. The need for well-staffed community facilities is therefore evident and pressing. There is a trend toward day programs for hearing impaired children, which has now reached the point where more than 50% of the children in the country are attending day programs. This situation results in no less of a requirement for psychological and consultative help for parents of children with mental, emotional, and hearing loss complications. Likewise the need for diagnostic teaching to arrive at the true nature of a child's handicapping conditions will continue to be required; and it is through university-affiliated training facilities that techniques, equipment, and staffing must be provided to a greater and greater extent.

Today there are a number of children, who have come to our attention at the Alexander Graham Bell Association for the Deaf, whose handicapping conditions are not completely understood. Within the last week I have received a letter from a mother in South Carolina who, after a year of visiting a variety of clinics and programs to the limits of her financial ability, has received a tentative diagnosis of "infantile autism aggravated by a moderate to severe hearing loss." The mother writes asking what she can do with and for her child, and adds that her financial situation is such that she cannot afford a private residential situation. The state school for the deaf is not equipped to handle the child. It is possible then that some treatment at a community or universityaffiliated center for the mentally retarded, such as will be provided in S. 1099, might provide the key to understanding the child's difficulties and how he can best be educated.

This case illustrates the doubly unfortunate situation in which parents of mentally retarded hearing impaired children are also handicapped by poverty and thus are unable to take advantage of facilities to help their children if such facilities cost anything more than a very minimal amount.

Dissemination

I can enthusiastically support the provisions of this Bill, as well as H.R. 6430 and S. 389, in support of programs for the dissemination of research and demonstration information to the using teachers in the classrooms. The instructional materials centers, mentioned by Dr. James Gallagher in testimony before this Committee on October 11, represent one of several such moves on the part of the U.S. Office of Education to make available to classroom teachers, therapists, and others working with handicapped children, the latest and best in the way of commercially available equipment. Likewise, the trend toward development of equipment, publications, and techniques (in response to the teachers' requests) at these Instructional Materials Centers represents a further step in meeting the needs of the frontline personnel working with handicapped children. The program, supported by research and demonstration funds of the U.S. Office of Education is a positive stride forward toward meeting the needs of the classroom teachers being trained and who will not be able to fully accomplish their task until they have had the benefit of the latest and best in the way of equipment, publications, and techniques. The Educational Research Information Center-Clearing House for Exceptional Children is another example of steps being taken through the U.S. Office of Education to make researchers. classroom teachers, and others in the field. acquainted with the latest research in education. I am most pleased that the Alexander Graham Bell Association for the Deaf is able to have a share in this information center activity, doing the abstracting of research and other documents in the area of the hearing impaired.

Of course, for years we have had the privilege of working in close cooperation with the John Tracy Clinic under the capable direction of Mrs. Spencer Tracy. We send free kits of information to parents of hearing impaired children when they are referred to us by the Tracy Clinic and, in turn, refer parents of preschool children to the Tracy Clinic for home study.

The Role of the Voluntary Health and Educational Agencies

We fully recognize, Mr. Chairman, that the passage of this Bill is not the answer to providing the facilities envisioned. We recognize the need for an ap

propriation that will enable this program to go forward as your Committee has visualized it. In seeking to meet the challenge of helping these hearing im paired youngsters, I can assure you that we will bend every effort to encourage the Appropriations Committees of the Senate and the House of Representatives to appropriate for this Bill the complete amount that has been recommended. May I again thank you for this opportunity of speaking out in support of S. 1099 and the companion Bills.

PREPARED STATEMENT OF AMERICAN PUBLIC HEALTH ASSOCIATION

The American Public Health Association is pleased to give its wholehearted support to the legislation before this Committee, the Mental Retardation Amendments of 1967. The need for broad Federal support for community-based services for the mentally retarded long has been recognized by the APHA. In 1964, following enactment of the Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963, American Public Health Association's Governing Council urged that "Federal, State and local agencies responsible for planning new community mental health and mental retardation facilities and services adopt policies that will direct, guide and develop the maximum use of general hospitals, local health departments and other established community services in extending care to these patients, and overcome the isolation of mental health and mental retardation services."

Since then, the confidence of APHA in the concept of Public Law 88-164 has been reinforced by the heartening results obtained from university affiliated and community based facilities for helping the mentally retarded find useful places in our society. Anyone who has seen the happiness brought to the retarded and their families by the opportunities provided under these programs would find that to be adequate return for the investment in facilities for training and educating these people. But, in addition, significant numbers of the six million or more mentally retarded Americans are being trained to hold jobs that contribute to the economy. This provides a return on the investment made through these programs that promise to make them good business. The retarded. it is being found, can perform many relatively simple but essential tasks that had never before been thought possible.

An interesting example was shown recently by a bank which found that retarded persons could, with great patience, perform check sorting operations more efficiently-and more cheaply than a computer. As the university and community centers continue to function, more means will be found to keep these people occupied in useful tasks. The more severely retarded, who may not be educable but who can be trained, are being helped in these centers by dedicated workers to care for themselves in order to ease the burden on their families and reduce the number of workers needed to look after them. Then, of course, there are the profoundly retarded who very frankly cannot survive without help.

A center cannot function without professional personnel, however, and it is with this in mind that American Public Health Association particularly wishes to urge the committee to give its approval to provisions in the Mental Retardation Amendments for assisting communities in the initial staffing of facilities for the retarded. This grant program is similar to that which has served Community Mental Health Centers well. Federal participation would be at the level of 75% for the first fifteen months, 60% for the next twelve months, 45% for the next twelve months and 30% for the last year. Initial is the key word in this provision. Only services in new federally financed facilities or services that have not previously been furnished would be eligible for the grant funds. It is quite evident that once the facilities for helping the retarded are provided, there is a need for adequately trained personnel to put them to use. The communities. which already will have provided matching funds to establish the facilities. may be expected to have difficulty financing the services. The APHA believes it is essential to see that these programs for the retarded follow through by insuring availability of necessary professional personnel.

The American Public Health Association supports the provision found in S. 1099 which would extend through fiscal 1972 the authority to train educational personnel to work with the handicapped, as well as extend a program of research and demonstration activities in the area of education.

In addition, the APHA also would like to express support for the concept of S. 2513, before this Committee, which would amend the Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963 to provide assistance for specialized training of physical educators and recreation personnel to help retarded and other handicapped children. This bill also would support research and demonstration projects relating to the physical education and recreation of such children.

In short, the American Public Health Association believes that the strong support for aiding the retarded, shown by the Congress in 1963 and by the Department of Health, Education, and Welfare since then, has been extremely justified. The APHA would like to see this support continue and grow.

The CHAIRMAN. Thank you.

We know how busy you are and the demands on your time. We certainly appreciate your taking the time to appear before us.

The committee now stands in recess.

(Whereupon, at 12:04 p.m., the subcommittee recessed subject to call of the Chair.)