dominance. But what it means I do not know." As to treatment, Dr. Goldberg mentioned the "proven techniques" of the

reading teachers and their use of visual-auditory-kinesthetic and tactile stimuli to reinforce the learning process. "The teacher is capable of teaching and we should confine ourselves to diagnosis and the elimination of secondary factors that might retard learning."

As to etiological factors in reading retardation, Dr. Goldberg emphasized that there are many, but there is no one factor. A child is not one who has only one facet of disability. He discussed at some length various factors such as the mental age of the child when he enters school at six, the overcrowded condition in many schools, the effect upon the child of delayed diagnosis and failure, emotional stresses arising in the home, the finding of abnormal E.E.G.'s in a high percentage of children showing perceptual difficulty in their attempts at drawing, the high IQ's, and the fact that although some children can learn to read rapidly by the sight method of teaching reading, these children would read well by any method and "there are certain children who because of brain damage, because of educational factors, or because of emotional stresses are not going to learn to read by the sight method and these children must be dealt with differently. That is the reason for early diagnosis, so that a specific type of teaching can be followed."

The indivisibility of the child makes it essential both that each discipline stay within its own field of competency and that the diagnosis be done on a group basis. "It cannot be done by the ophthalmologist. It cannot be done by the neurologist, educator, or the orthoptic technician. If we look upon every child as an indivisible child we will reduce this high percentage of disabilities in reading."

D Y S L E X I A , H E A R I N G , AND S P E E C H DISORDERS At THE JOHNS HOPKINS CONFERENCE ON RESEARCH NEEDS IN

DYSLEXIA in 1961, WILLIAM G. HARDY, PHD., associate professor of Otolaryngology and Environmental Medicine and director of the Hearing and Speech Center at that institution, presented a paper on Dyslexia in Relation to Diagnostic Methodology in Hearing and Speech Disorders.*

Dr. Hardy outlined the clinical approach in assessing the functioning of a child's auditory system, starting with his sensitivity to the physical proper- ties of sounds, his discrimination and recognition of intensity, frequency, phase, etc., and then considering the various cerebral activities involved in the proc- essing, patterning, and retention of the auditory input, including the develop- ment of language comprehension and use. The clinician in this field faces the daily task of differentiation between many kinds of hearing impairments and a disorder of language, and must also be aware of the emotional instability often seen in these children. In working with pre-school children, who are still in a pre-reading stage of development, Dr. Hardy said, "We frequently find that a given child tested with non-verbal tasks has just as much difficulty

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in the serial-order temporal integration of visual information as he does with auditory" . . . "A child who is only classically deaf, in terms of profound loss of auditory sensitivity, and who is not otherwise defective, is expected to show clear evidence of considerable facility in lip-reading by the age of three. If he does not, the chances are very good that he has problems in the management of visual information."

In regard to auditory training, Dr. Hardy pointed out that the ancient Greeks had observed the importance of listening to one's own speech in the process of modeling it after the speech of others, and thought much of the importance of "ear training." . . . "Now called 'auditory training,' it is the basic remedial procedure employed by speech clinicians the world over when working with children with infantile speech perseveration. Of the children who cannot learn well this sort of critical auditory self-monitoring, it would be most interesting to know more precisely how many have problems in visual as well as auditory processing and retention."

Dr. Hardy further discussed the children who show "some of the most subtle clinical problems in speech and hearing" and do not show classical neurological symptoms of brain injury but usually have some central nervous system peculiarities. "Somewhere in the various reverberatory circuits of the brain, possibly involving several systems, there are inadequacies in the feed- back circuitry." He reasons that this is what may be involved in much of dyslexia "an inadequacy in the reinforcing mechanisms which make process- ing, pattern-formation, and retention possible and productive." The application of the methods of auditory analysis to the visual processes in temporal terms, the testing procedures of those working upon the development of thought processes and problem solving, further study of the causal, developmental, and behavioral relationships between hearing and speech disorders and dyslexia would be fruitful, and finally "there needs to be a much closer relationship between clinical methods and findings and educative arts and skills--first, in an attempt to understand the nature of dyslexia in a given child and then do something productive about it."

C U R R E N T STUDIES In response to a query from THE BULLETIN, Dr. Hardy kindly sum-

marized the continuing concerns of his group at Johns Hopkins: "We are trying to learn something more about the content of the 'hierarchy' involving the relationships among hearing and auding at what might be thought of as a pre-language stage of input. Indeed, one may present a strong argument to the effect that auditing involves, with auditory feedback and speech output, some of a child's most important gestalten as early underpinnings of the language-speech act. Interestingly enough, several of our little subjects have quite as much trouble with visual as with auditory integration."

* Cha~ter 11, READINIG DISABILITY--PRnGRESS AND RESEARCH NEEDS IN DYSLEXIA, ed. John Money, Baltimore: The Johns Hopkins Press, 1962.

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