Whatever the importance or otherwise of lipreading in the context of the devastation of WW1, the fact remains that many countries made provision via lipreading tuition for deafened servicemen returning from the conflict.
Amid masses of detail across the globe it is almost impossible to say with certainty how many people were deafened due to their participation in the war. The nearest figures for British servicemen are recorded as being 2% of people being pensioned from the army because of disability were pensioned because of deafness or ear disease. The USA put this figure as maybe as low as 0.5% of people, reasoning that their soldiers were more rigorously tested before joining the army and that most of the noisy trench warfare was all but over when they entered the war.
Given sustained noise exposure for many of levels of up to 185db, these figures seem particularly low and are an indication of how deafness was perceived across societies in relation to more visible wounds and disabilities. In any event, the number of men ultimately attending lipreading tuition was invariably lower than the number anticipated.
In Britain the initial test for a person getting accepted into the army was a written test, one which the sergeant would often fill out on behalf of the man since the man may have had trouble filling out forms or reading them. The questions relating to the form were spoken face-to-face, so it is reasonable to suggest that a person with partial deafness could easily have passed the test through lipreading the sergeant, observing verbal clues and being lucky with a certain amount of guessing to yes/no answers. The desperate need for men to pass this test was also a very significant factor in this success rate.
The first reference to lipreading after the war had begun is that of three deafened soldiers being given lipreading tuition in Germany three months from the start of the war, following the German philosophy that instruction should begin as soon as the person was out of the doctor’s care. The soldiers were two lawyers and one teacher, an indication of the level of education anticipated initially for lipreading tuition, who were said to be able to return to their regular occupations following such instruction. Germany recorded that a soldier required five to six months of lipreading tuition, which would suggest that these three people could have been taking part again in their regular vocations as early as April 1915.
The German War Office established the first centre of instruction for training all deafened soldiers, though this had issues in that it was generally thought that a person should receive instruction in a facility near to their home, for reasons of different dialects, rather than all deafened people being congregated in one place.
A pamphlet by EJ Moure and P Pietri printed in France in two parts across June and August 1916 entitled ‘The Auditory Organ in War Time’ provides detailed information on looking at the causes of deafness and ultimately advocates ‘repeated examinations, static and auditory, of the organ of hearing by the most recent methods’ and ‘review in six months or a year for a definite opinion’. We could reasonably presume that such information being available on the causes of deafness would lead to, or would already have led to, lipreading tuition being a part of the treatment to alleviate such deafness.
Equipment and hearing aid devices were very primitive at this time, in comparison with today’s technology, and the most likely hearing aid device available to a deafened soldier – if any were available at all – would have been a bulky electronic device or slightly later, a banjo hearing aid. Neither of these hearing devices, because of their cumbersome use and difficult positioning, were particularly conducive to effective lipreading.
Although French and Italian otolaryngology services were well established at this time, there seems to be no evidence of any standard ear protection being available and used by any nation during the war. Protections suggested included Plasticine wrapped in gauze or alternatively forming an artificial drum with Vaseline and cotton wool. If these methods were used at all, there is no evidence of their effectiveness or otherwise. This is again perhaps a reflection of deafness not being regarded with the same seriousness as other differences and disabilities during the war.
In Great Britain, the first lipreading classes were not established formerly by government but instead by the Edinburgh Lipreading Association and these were led by Mary E. B. Stormonth. The first class occurred on 1st May 1917 and is recorded thus:
‘A small number of men were with some difficulty collected from all parts of the United Kingdom, and were lodged or billeted through the generosity of the association.
The teaching was excellent and the results most satisfactory, but, of course, the scope of the voluntary association's activity was necessarily a limited one, and, as Miss Stormonth said, State recognition was indispensable’
The report on the inter-allied conference for the study of professional re-education and other questions of interest to soldiers and sailors disabled by the war by Lieutenant-Colonel Sir A Griffith Boscawen (Parliamentary Secretary to the Ministry of Pensions) from 8th – 12th May 1917 records very little information directly related to deafness compared to other disabilities and sums up the necessary support suggestions in three brief paragraphs. Here we see that lipreading tuition is given great significance and we also see recognition that deaf people can be a great support to one another. The section of the report reads:
'For the deaf:
90. Lipreading should be regarded as the only useful method of re-educating those who are totally deaf in both ears. Instruction should be given them by teachers in deaf mute institutions and not by amateurs.
91. From the point of view of social intercourse re-education of the ears, designed to enable the deaf to use such powers of hearing as they may still retain, should begin at the same time as lipreading.
92. It would be useful to establish a brotherhood of those who lost their hearing in the war, to bring them together and reconcile them to their changed conditions of life.'
Following this, by September 1917, the USA had also formulated a plan for the reconstruction of their patients suffering from defects of hearing and speech, under the leadership of Col Charles W. Richardson.
Initially this contained only the following information and considerations, focussing again on lipreading (or speech reading as the Americans termed it) being the significant factor in re-education:
(1) Consideration of the methods of physical treatment of defects of hearing and speech at the front.
(2) The re-education of the deaf and the correction of speech defects, at the front, immediately after the injury or disease; transportation to the interior district where the re-education would be begun, or transportation to the United States where the re-education could be carried on under better circumstances and to better advantage.
(3) To employ only one method-that of speech reading- in the re-education of the near deaf or the completely deaf, except in the few cases in which the manual method might be necessary.
(4) Necessity for a school to train teachers, the available supply being too limited to meet the expected demands.
(5) Provisions for any plastic operations preceding the teaching of speech correction could be instituted.
(6) Consideration of the question of rehabilitation, especially with reference to those suffering from defects of hearing.
Additions to these considerations later included a huge variety of detailed information on re-education of deaf people, even making plans for eventualities that never materialised, as the number of deaf people presenting for lipreading tuition was here again lower than anticipated:
(1) A canvass to be made of teachers of lipreading and of corrective speech in the United States, with a view to employment.
(2) The physical treatment to be done abroad, the correction of deafness, so far as practicable, through local treatment, rest, and removal from the din of battle. Through this means the temporarily deaf and the moderate defects in speech were to be separated from the permanently deaf and the apparently incurable defects in speech.
(3) It was not feasible to start re-education abroad because of the difficulty in selection and segregation; unfavourable environment for the teaching; difficulty in maintaining proper supervision of re-educational work of this type.
(4) Though the work could be done in a reconstruction hospital, it was desirable that an institution devoted exclusively to this purpose be used. There were to be one supervisor and six teachers for each section of 50 beds.
(5) The personnel of each teaching centre was to comprise one head teacher in lipreading; one teacher in corrective speech, who was to give one lecture per week for four months; one volunteer otolaryngologist to lecture on anatomy and physiology of the ear, nose, and throat.
(6) Cadet teachers were to be selected for the training classes through the cooperation of the women's committee of the National Defence Council or a similar committee of the American Red Cross; to be at least 25 years of age. Each cadet teacher was to have the equivalent of a normal-school education; to receive no compensation while in training, and $60 per month, with lodging and board, after employment.
(7) Training schools were to be established in 10 large centres, independent of established schools, each school to give two courses - total expense, $1,400. Ten additional teachers were to be employed in order to give an intensive individual course.
(8) This re-education service was to be placed under a qualified man, preferably medical, who was to be responsible for the development of the details of the training classes. The courses were to be standardized, and were to include a thorough training in the proper formation of the elements of speech, gymnastics of the tongue, proper breathing and calisthenics necessary in the development of the breath and voice, lectures on musical vibrations, special work in the development of hearing with music, and voice placing.
(9) Curative workshops were to be established at each reconstruction institution where these classes of patients were received for such occupations as carpentry, painting, mechanical drawing, printing, iron- work, wood turning, metal work on lathes, boot-making, bookbinding, broom making, mattress making, rubber working, and gardening. The advice of civilians suffering from similar defects was to be obtained as to occupations which it would be best for these men to follow. Public employment agencies and industrial organizations were to be convinced that the deaf were not abnormal people in that they had substituted another sense for one in which they were handicapped.
Reactions to the rehabilitation of the anticipated numbers of deafened men around the world were now moved significantly forward from those initial three professionals attending the first German lipreading tuition in 1914/15.
By 1918 the UK government had established its approach to deafness and lipreading tuition with the creation of a Special Aural Board under the presidency of James Dundas Grant. The Board was set up originally in London with four aural surgeons and one specialist in instruction in lipreading. The purpose of the Aural Board, aside from determining the level of a person’s pension, was to examine a man for his degree of disability produced by deafness and to determine whether the man was suitable for lipreading tuition. Special headquarters were established at Number 28, Park Crescent, London and business was mainly transacted by a man named Captain Ingram.
The Aural Board was financed by the treasury, through the Ministry of Pensions, with a fund manipulated by the Office of Liaison between the War Office and the Ministry of Pensions financially supporting a school of lipreading based at the headquarters.
As time progressed, regional sub-divisions were created and these were made up of one aural surgeon and one specialist in lipreading. Here in the Northern region these were James Don, M.D and Mr D Baldie.
An important distinction between the approach of the UK and many other nations (USA, France, Germany, Italy) was that the UK soldiers had already been pensioned from service because of their deafness before the process of being identified for lipreading tuition had started, whereas in other countries the soldiers were still under strict military discipline at the time they were undertaking lipreading tuition. In the USA a single venue for rehabilitation and lipreading tuition was ultimately established as General Hospital No. 11, Cape May, New Jersey and the service was inaugurated on July 24th 1918.
Amid the all the reaction to determine the levels of a man’s deafness, and therefore his eligibility for lipreading tuition, there is no specific information related to any one particular Aural Board test on record. There is however enough generic observational information in existence to let us know the likelihood of how such a test would have been conducted. Below are examples of types of test rather than observations from a specific recorded test:
The assessment was carried out by the assessor and observed by one other person. Prior to the assessment the assessor informed the examinee not to behave dishonestly during the test. The assessor explained that the examination would be carried out on each ear separately.
The assessor never hurried the assessment, gauging that the examinee was more likely to slip-up and be found as a malingerer the longer they were in the examiner’s presence. Malingering is an intentional desire on the part of the examinee to make the examiner believe that his hearing is nil, or less than it actually is, in one or both ears. A man might often choose to be a malingerer in order to maintain or receive a pension.
Tests may have been conducted with any or all of the following, alongside primitive medical tests using a tuning fork, and for the benefit of simplicity these are sectioned into numbered tests here:
Test One (the test ends when the examinee is no longer able to repeat the sequence or list in full)
The assessor stands in close proximity behind the examinee and says a list of four colours aloud to each ear of the examinee. The examinee is asked to repeat the list of four colours.
The assessor stands 2 feet behind the examinee and says aloud a list of four sequential numbers to each ear of the examinee. The examinee is asked to repeat the sequence of numbers.
The assessor stands 9 feet behind the examinee and says aloud a list of four foodstuffs to each ear of the examinee. The examinee is asked to repeat the list of foodstuffs.
The assessor stands 18 feet behind the examinee and says aloud a list of four unrelated words to each ear of the examinee. The examinee is asked to repeat the list of unrelated words.
The assessor stands in close proximity behind the examinee and asks the examinee to raise his hand when he hears the ticking of a watch in either ear. The right hand should be raised if the ticking is heard on the right side. The left hand should be raised if the ticking is heard on the left side. The examiner may not use the watch at all or use it on one or both ears. The examinee may sometimes be blindfold during this test. Any reaction or non-reaction of the examinee will be recorded.
The assessor stands approximately 5 feet behind the examinee and bangs a fist or an object, such as a gavel, a number of times onto the table or other hard surface. The examinee is asked to state how many times the banging sound has been heard.
The assessor repeats the exercise by tapping a number of times more quietly on the table. The examinee is asked to state how many taps he has heard. The examinee may be blindfold during this test.
The assessor asks the examinee to stand in a corner with his fingers in his ears and his back to the assessor. The assessor then creates many sudden loud noises, such as banging sounds, trolleys rumbling, hand claps and the like. These last for anything up to twenty minutes and the reflex actions of the examinee are monitored.
Test Five (Parts 1 & 2)
(Part 1) The assessor sits down one-to-one with the examinee and strikes up a general, natural conversation on a favourite topic of the examinee. After a few minutes of conversation on this topic the assessor, without explanation or warning, changes the topic subject and continues with the conversation in a natural way. The examinee is being tested on their ability or otherwise to move from one topic to another having been given no warning.
(Part 2) At the end of this conversation the assessor explains that the assessment is complete and that the results will be relayed to the examinee soon. He thanks the examinee for his time and lightens the mood a little to help relax the examinee. As the examinee prepares to leave and heads for the door, the assessor asks an innocuous question in an informal manner from behind the examinee. The assessor registers the examinee’s reflex response to this question.
On completion of the assessment an estimation is made of the percentage of deafness in each ear of the examinee. The results were measured using the following scale:
1) The examinee has been assessed as having 70% deafness or more in both ears. This is classed as total deafness.
2) The examinee has been assessed as having 70% or more deafness in one ear and 60-70% deafness in the other ear. This is classed as total deafness, one ear; nearly total other ear.
3) The examinee has been assessed as having 50% deafness in both ears. This is classed as extremely deaf.
4) The examinee has been assessed as having 70% deafness in one year and 30% in the other ear. This is classed as total deafness, one ear; moderate deafness other ear.
5) The examinee has been assessed as having 50% deafness in one ear and 30% in the other ear. This is classed as extreme deafness, one ear; moderate deafness other ear.
6) The examinee has been assessed as having 70% deafness in one ear and no deafness in the other ear. This is classed as total deafness, one ear; normal hearing other ear.
7) The examinee has been assessed as having 20% deafness in one or both ears. This is classed as moderate deafness, one or both ears.
8) The examinee has been assessed as having normal hearing in both ears. He is a malingerer.
With all testing complete, those eligible for lipreading were assigned quickly to their relevant tuition. This now included men of all rank and intellect, with the USA claiming that ‘even cases of the most unpromising character, seemingly of the lowest type of mentality, acquired the speech-reading with unusual facility’.
The UK, USA, France, Germany and Italy appear to have concluded that the best way to deliver lipreading tuition to greatest effect was for the man to have one half hour lipreading session in the morning, a second half hour session in the afternoon and an optional third half hour session in the evening, depending on his other commitments and occupations.
Between sessions, men were given mirrors to study their own lip movements independently and other uplifting and educational activities were provided, such as watching a silent movie to follow lip patterns or watching a film show of a man uttering a string of simple phrases to illustrate ordinary conversation, which the deafened men then repeated aloud as they lipread the screen. There was also educational entertainment in the form of comedians demonstrating facial expressions and telling stories whilst a strong light was thrown upon the face, allowing the watching deafened audience to demonstrate their powers of lipreading.
Lipreading course duration was limited. Men were expected to return to purposeful occupations upon the completion of their lipreading course, having overcome their hearing deficit and weren’t expected to stay on the course indefinitely. In Germany the expectation was that the course would last five to six months, in France and Great Britain the estimate was three to four months, whilst the USA believed their approach worked in even quicker time. An example of this was their claim that, ‘Men who could neither read, write, nor figure would acquire the elements of speech reading within a week to 10 days’. This is further illustration that men of all ranks and abilities were being regarded as eligible for lipreading tuition.
Class sizes tended to be 6 – 8 people, with more people included for more advanced lipreading tuition, so that, with a more pronounced circle of people, those sitting to the side could view lips in profile as well as straight on.
This was an intensive process of lipreading tuition and it was designed with the specific purpose, as stated, of getting the men back to purposeful occupation as quickly as possible. Much of the language of the time used by those who advocated lipreading tuition left no doubt as to their expectations of lipreading either overcoming deafness or lipreading as a substitute for deafness:
‘With lip-reading thoroughly mastered, the deafened soldier is re-accustomed to social and business relations’
‘(He) Is more than anxious to remove this one handicap so as to be restored to normal’
‘to restore his capacity for mingling and communicating with his friends and business associates with the least possible embarrassment’
‘To have neutralised (his) disability’
‘To become again a social being, cheerful and confident’
‘When the deaf man realises that he can again understand the quietly spoken word his attitude towards life is changed’
With so much emphasis being given to lipreading tuition as a means of overcoming deafness, a lot of value was placed on the results of such tuition. How these results were measured is impossible to say, as remains the case today, as the accuracy of lipreading depends on so many factors
– tiredness, light, emotion, placement, obstructions – and we can’t be sure of the circumstances surrounding how any of the results below were measured. However, the following results on lipreading tuition during the war do exist and it is useful to consider them in relation to society’s expectations upon the completion of a lipreading course:
From 73 men undertaking lipreading in France reported from the Institution at La Perasagotiere, the following is recorded as to their standards reached:
Very Good 10
Fairly Good 5
Not re-educable 2
What happened to those who were ‘Not re-educable’ is unclear and we cam only presume that the three missing cases (the total here adds to 70 not 73) were men who either were not tested or, for whatever reason, failed to complete their tuition.
Great Britain set up a similar system and reported similar feedback. The system was classified thus:
(cases whose lipreading attainments place them practically on the level of hearing people; that is to say, they lip-read a stranger as though they were practically in full possession of ordinary hearing power)
(cases possessing a useful acquirement of lip-reading, and who respond either (a) after not more than a single occasional repetition, or (b) after they have repeated the question as lip-read in order to make certain that they have understood rightly)
(cases are able to respond to simple sentences only, and require questions to be repeated from three to five times before they apprehend rightly)
(cases respond merely to single words after frequent repetition)
From 16 men who completed the full-time day course the results were as follows:
Entirely satisfactory 5
From 20 men assessed midway through the full-time day course the results were:
Entirely satisfactory 3
From 35 men who attended the evening classes the results were:
Entirely satisfactory 19
Fairly satisfactory 2
Unable to be classified owing to short attendances 9
We are again left to wonder what became of the men who were unsatisfactory lipreaders or of those who failed to complete the tuition. We are also left to wonder how broad the term
‘practically on the level of hearing people’ is within the Entirely Satisfactory category.
The accuracy of testing of lipreading remains difficult, and whether here all testing was taken under the same conditions for each person and whether those conditions were made more conducive to more positive results is unknown. There is no clear evidence of deafened men returning to purposeful occupations either, however proficient their lipreading abilities. The ultimate historical record of how effective lipreading tuition during the war was remains inconclusive and was, in all probability, likely to have been varied in success rates on an individual basis, rather than have been the sole answer to combatting deafness for all that so many people had hoped.
As late as November 1918, General Hospital, No 11 in the USA made the following classifications:
58 patients were enrolled as having defects of hearing
34 were discharged as well-qualified speech readers
3 discontinued treatment
11 were enrolled in the training for defects of speech
4 were discharged cured
2 were transferred to other hospitals
Upon the closing of General Hospital, No. 11 the school for the correction of defects of hearing and speech was transferred to General Hospital No. 41, Staten Island, New York and of the twenty deafened men transferred, the majority completed their lipreading course before 1st September, 1919.
With the end of the war, lipreading tuition was manoeuvred into a complex place. The necessity for men to overcome deafness to contribute to the post-war effort faded and funding for support to deafened people became a less clear issue. This combination, with the addition of numerous social and cultural changes, led through time to what lipreading tuition means in today’s society.