Given a necessary amount of training, it is almost possible for them to do anything. As you say, there is no special exception made for the deaf, even though we have made exceptions for the blind, in the social security and tax laws and otherwise. There is no place where there is a special exemption for the deaf.

Mr. HESELTON. Any further questions?

Mr. ROBERTS. Mr. Chairman?

Mr. HESELTON. Mr. Roberts.

Mr. ROBERTS. Doctor, I have had the pleasure of visiting the college out there, and I think it was one of the best deals I have ever had in Washington. I was out there at one of the graduation exercises. Do you have any hospital facilities for the students out there?

Dr. ELSTAD. No. When I came there 8 years ago we did not even have a nurse, but we have a nurse now; and we have a hospital room in the men's dormitory and 1 in the girl's dormitory and in 2 of the smaller dormitories we have 1 room set aside. If there is an illness, they have to go to a hospital in the city.

We have now an insurance policy that covers both sickness and health; that they all have, that they all take advantage of.

Mr. ROBERTS. Is that premium paid by the student?

Dr. ELSTAD. If he can. Vocational rehabilitation pays it in some States. It is 100 percent.

Mr. ROBERTS. Separating the administrative expense from the expense of food and the textbooks and equipment, about what would your average spending on each student there in the school be?

Dr. ELSTAD. Well, as I said awhile ago, it costs us around $1,600 for the whole expense, the per capita cost. I would say about $1,100 of that would be for teaching. About $500 or $600 would be for maintenance, I would say. I cannot give you the exact figures. Mr. ROBERTS. Does the $1,600 figure include everything?

Dr. ELSTAD. Everything.

Mr. THORNBERRY. Food?

Dr. ELSTAD. That is rather low, compared with the country in general. I think on the average per capita cost some of them go as high as $2,200, such as in the State of Illinois.

Mr. ROBERTS. It would not include clothes, of course?

Dr. ELSTAD. No. We give nothing for that.

Mr. ROBERTS. That is part of the student's expense?

Dr. ELSTAD. Yes.

Mr. ROBERTS. I have a fine school for the deaf in my district in Alabama, the Alabama School for the Deaf and the Blind.

Dr. ELSTAD. True.

Mr. ROBERTS. I do not know whether you know about that.

Dr. ELSTAD. I know Dr. Ryan.

Mr. ROBERTS. Do practically all of the States and Territories have schools for the deaf?

Dr. ELSTAD. Every State, with the exception of Delaware, New Hampshire, and Nevada, has a State residential school like Alabama has. Those States will send them to the neighboring State and pay the full cost there.

Mr. ROBERTS. Most of those schools teach through senior-high school?

Dr. ELSTAD. No; they do not. They go through about the 10th year. That is why our college, for instance, has 5 years. It has a preparatory

year which bridges the gap between what that school does and what is done in the freshman class. We have a 5-year course.

Mr. ROBERTS. You maintain, I assume, very close liaison with the schools in the various States, do you not?

Dr. ELSTAD. We do.

Mr. ROBERTS. Do you have any kind of a part of the year set aside where representatives come here and go over these problems, or is that mostly through the deaf associations?

Dr. ELSTAD. No. That is done usually from the administration office in that school with their school. Two years ago we had an institute where we invited students from the various schools to come, with the idea of looking the place over. We had 90 students who came from 30 States for a week. We put them up for a week. They paid their transportation. It was a very fine experiment. It was hard to find sleeping space for them. We were surprised to get so

many.

The standards in the various schools are not the same. We are trying to see if something can be done about that. We take the State certification, usually.

For instance, Alabama would certify nine students as qualified. We would take them on the certification. Now our examination is an examination of exclusion, because we cannot take more than a few, so we have to have some way of keeping them out. That is the way it is done, by examination.

Mr. ROBERTS. What type of academic degree do you confer?

Mr. ELSTAD. B. A., B. S., and occasionally they can come back for an extra year's work.

For instance, this year we enrolled a girl who was a graduate of Augustana College, Rock Island. She is a deaf girl from Augustana College, Rock Island. She wants to teach the deaf physical education. She cannot get a teaching position unless she has education credit, which she did not get. She is coming to us for a year to take our education course for the year, and she is going to work her way through by helping us with physical education. She will go out at the end of the year with her credits that she needs and she can get her position as the physical education teacher in a school for the deaf.

Mr. ROBERTS. At most of the State institutions-I know of one at Talladega, Ala.-they conduct various forms of enterprise, such as sewing and that sort of business, for people who are not necessarily in the school. The people who are deaf come in there and make these things and then put them on the market. That is done at Talladega by both the deaf and the blind. Is any of that type of work done there at Gallaudet, or is it strictly academic?

Dr. ELSTAD. It is strictly academic, but as we expand, our offerings are going to have to be more diversified. For instance, there will be drafting and business courses. There is a demand for that now. We have hard enough times getting the staff to teach the college courses, without branching out. That is coming.

Mr. ROBERTS. In other words, you do have in mind that the trade school feature will be developed?

Dr. ELSTAD. That is right.

Mr. ROBERTS. For those who do not prefer to go through the academic part. If they want to learn a trade, that will be possible?

Dr. ELSTAD. That is right. They can have an associated arts course. There would be 2 years of college, with terminal courses, so that they can leave at the end of 2 years and be given a credit for it.

Mr. ROBERTS. Of course, that would naturally call for additional appropriations from the Congress?

Dr. ELSTAD. That is right. We got no money for additional staff this year, but in the hope of getting the necessary instruction I hired 5 new instructors for $20,000. As a result of this work, we are getting it done.

Mr. ROBERTS. Off the record.

(Discussion off the record.)

Mr. ROBERTS. We appreciate the fine work you are doing up at that college.

Mr. HESELTON. Doctor, you gave a figure earlier as to the economic loss by reason of deafness, did you not?

Dr. HARDY. 300 million man-hours is the best generalization that has been arrived at by a pretty responsible survey.

Mr. HESELTON. Nobody has translated that in terms of dollars? Dr. HARDY. No, sir; you would have to go through the wage scale. It amounts to quite a bit.

Mr. HESELTON. This committee in the last week or 10 days has had some very difficult if not unsolvable problems presented to it in terms of these various diseases which have been discussed. I would think that Dr. Elstad's presentation offered one of the most immediate means of helping to minimize that economic loss, as well as to make people who are unfortunately deaf have a much happier and fuller life.

Dr. HARDY. That figure, Mr. Chairman, does not relate to this group. That is exclusive of this group of deaf people. This relates to the status of hearing disorders in general in the population, exclusive of the deaf group. They were not included in it at all. This is man-hours lost of productive activity of folks who have been going along.

Mr. HESELTON. Yes. But in terms of young people who are handicapped and thereby not able to prepare themselves for a productive life this institution here will be a marvelous thing.

Dr. HARDY. That has never even been counted.

Mr. CROSSER. Mr. Chairman?

Mr. HESELTON. Mr. Crosser.

Mr. CROSSER. Referring briefly to your subject of heredity, suppose that you had a father who was absolutely deaf and dumb, as we understand it today, and a mother who was likewise, except that she might be able to make out what a person might say. What would you say about the likelihood of the children, if they have any in such a case, being affected?

Dr. HARDY. As a scientist I would have to ask one more question, Congressman. What caused the impairment in either one or both of the people?

Mr. CROSSER. Well, of course, now, the father was a minister. He preached in a deaf-and-dumb church. The wife was a mother. They were both deaf and dumb.

Dr. HARDY. I cannot answer it intelligently because of that factor of causal determination which is critical to it. In the normal course of events it is quite natural to expect, and it does commonly happen, that two people who have similar kinds of handicaps and are thrown together in a social group somehow or other get around to being

married. That is a social event which is totally unrelated in medical terms as to why they are deaf.

Mr. CROSSER. What would you expect?

Dr. HARDY. As a clinical scientist I naturally do not expect anything until we know more about the particular problem in all of its detail. Mr. CROSSER. The father I am speaking about could not understand me and I could not understand him. The mother could.

Dr. HARDY. If there had been similar instances back down in their family background and a variety of people who had arrived at the same point

Mr. CROSSER. The wife in this case was deaf. If I would speak very slowly and carefully she could understand what I meant, although she could not hear it.

I happen to know that they have 2 children, both grown up, and if you ever saw 2 very loquacious individuals those were the 2 children. Mr. THORNBERRY. Off the record.

(Discussion off the record.)

Mr. CROSSER. This man was an Episcopalian minister.

Dr. HARDY. One of the things the field in general is trying hard to get at is to find these children early enough and get the facts on them and try to see to it that those who do not need to grow up as deaf people do not grow up as deaf people. There are many steps to be taken to redeem them, if you will, rehabilitationwise, for many children who otherwise are let go and have no attention paid to them and who naturally have only that as a future.

Mr. CROSSER. Until I heard what my colleague from Texas has said, I had heard of no other case but this one.

Dr. HARDY. We can give you ample assurance that happens very frequently.

Mr. CROSSER. It was amazing.

Dr. HARDY. That was what I meant, sir, in the comment a while ago. Until better means of apprehending these various problems have been developed, there will be difficulties in solving them. A child may lose a great deal of his hearing at the age of 2. In prior years they just automatically put them in the category of deafness. In the view of many people he might as well have been born deaf because he never learned to talk. But actually what caused the impairment had nothing to do with prenatal experience.

Mr. CROSSER. These people were all educated people, although it was hard for them. They educated the children, and they were all well educated.

I suppose you are quite familiar with this new treatment by surgery operated by this man in New York. I cannot think of his name. Dr. HARDY. You mean fenestration surgery?

Mr. CROSSER. They go into a very delicate operation.

Dr. HARDY. That is Dr. Lempert you are referring to. That eurgery is a specific for only 1 kind of hearing impairment from 1 source. It is not generally applicable. For instance, it has no use at all for a nerve-type impairment.

Mr. CROSSER. Well, one of the doctors out at the Naval Hospital, I know, does a lot of successful operating with that.

Dr. HARDY. Yes.

I wonder, Mr. Chairman, if we should take a few minutes to get back to the general question of research in the field.

Mr. HESELTON. Yes.

Dr. HARDY. And some of the needs. Dr. Bailey, will you address yourself to that?

Mr. HESELTON. Before you proceed may I ask one question of Dr. Elstad.

Does the Department of Health, Education, and Welfare have any specific office whose duty it is to follow this education problem and rehabilitation problem?

Dr. ELSTAD. So far, up until this year, it was just on budgetary matters, but now there is a liaison man appointed, Mr. Baxter, who have five institutions. Ours is one. He has Howard, Columbia, St. Elizabeths, Freedman's and one other. We are getting excellent service from him.

Mr. HESELTON. Proceed.

STATEMENT OF DR. PEARCE BAILEY, NATIONAL INSTITUTE OF NEUROLOGICAL DISEASES AND BLINDNESS, PUBLIC HEALTH SERVICE

Dr. BAILEY. First of all, Mr. Chairman, allow me to excuse myself for appearing before this committee twice.

Mr. HESELTON. You are very welcome.

Dr. BAILEY. I assure you I am not trying to afflict myself on the committee, but the spectrum of diseases covered by our research institute is so large it cannot be covered in 1 day.

I would sort of like to make a few remarks on how we tie this up from a research program standpoint. As you heard in the testimony previously, our research responsibilities cover neurological and sensory disorders.

As you know, neurological disorders are diseases of the nervous system, and sensory disorders are diseases of the important end organs of the brain, particularly the eye and the ear.

Now, in medical practice there is a tendency to separate these disciplines. Thus we have the specialty of neurology, the specialty of ophthalmology for blindness, and the specialty of otolaryngology for deafness.

Now, in research we do not need these artificial lines of demarcation. They are all part of the same system. That is, the eye transmits light to the brain, and it is the responsibility of the brain for perception and interpretation of visual images. In the same way the ear conducts sound to the brain which is recorded, received, and interpreted by the brain.

Therefore, blindness can result from disorders of the nervous system or the eye, and in the same way deafness can result from disorders of the ear or the brain or both.

To show you the rather across-the-board nature of it, if you will remember last Wednesday we spoke of some work we were contemplating on regeneration of nervous tissue. Well, if such experiments prove practical the results would be beneficial to injuries of the nervous system and also to the visual system and to the hearing system. That is, you have the optic nerve and the brain in the visual system and the auditory nerve and the brain in the hearing system.