Not Just Lip Service

Not Just Lip Service was made possible by a grant from the National Lottery ‘Then & Now’ fund.
The project set out to make a comparison between lipreading tuition today and lipreading tuition as it was experienced by deafened servicemen of different nations during and after World War 1. The project began in November 2018 and was completed by the end of January 2020.
 
The content of the project was carried out via weekly meetings of members of deaf awareness: NE, individual research and drawing on the experiences of relevant professionals and existing written publications.
 
During the project there were opportunities for members to participate in lipreading practice sessions and also opportunities to visit places of interest such as the Thackray Medical Museum in Leeds and Durham’s Beamish Museum.
 
What follows is the story of all the information gained and discussed during this project. We thank you for your time reading through this information and we hope that it sparks as much interest and discussion as it did for our members on the topic of lipreading tuition and all its associated links with deafness and other communications.

Members of the group on a trip to Beamish Museum

Background

 

Lipreading is a term that has been in evidence for hundreds of years to describe the process that a deaf person uses to pick up clues from the face and lips of others when vocal language is not heard or is difficult to hear. Lipreading has been termed differently numerous times over the years (labiomancy, oral audition, visual hearing, speechreading, etc) and is still today felt by many to be an inadequate term for the process used.

 

The description of lipreading has also undergone numerous changes throughout the generations and an agreed, specific definition is no closer today than it was three hundred years ago.

 

Lipreading also has an interlocked history with sign language and, in the written recorded history of deaf people, it is often difficult to distinguish the degrees and types of deafness that are being referred to and it is therefore difficult to paint a clear picture of how deaf people were best supported in the past.

 

There are many historical references that refer to lipreading tuition being a means to help a deaf child in education to speak, which appears to have been the ultimate objective of the tuition. This contrasts greatly with the range of reasons that deafened and hard of hearing adults seek lipreading tuition today, which is about helping them to observe what another person is saying, rather than developing speech themselves.

History

 

Throughout recorded history deaf people have often been regarded as people of having lesser insight and intelligence than their hearing peers. The value of speech has been forever interlocked with this thought and history has brought forth numerous opinions and opposing views on the education of deaf people, the purpose of speech over sign language and the expectations of lipreading.

 

Below are some of the findings of our project that helped fix lipreading in its place at the outbreak of WW1 and helped us to think about how deafness was viewed at this time. The story is a long and complex one that had input from people the world over, and this is our condensed version of that story:

 

In 1470 Rodolphus Agricola held that a person who is born deaf could express himself by putting down his thoughts in writing and he documented teaching a deaf child to communicate both orally and in writing in his book, De inventione dialectica (On Dialectical Invention) printed in 1515.

 

The Italian philosopher and physician, Jerome Cardano (1501-1576), argued that it was important that deaf people had access to receiving teaching, which would allow them to use their minds and help them with developing speech.

 

By 1620 Spaniard Juan Pablo Bonet published his book Reducción de las letras y arte para enseñar a hablar a los mudos ("Summary of the letters and the art of teaching speech to the mute"). Though this contained an early form of sign language, it also set out to advance oral education for deaf people.

Image: A, B, C, D hand shapes from Bonet’s publication

In 1648 Englishman Dr John Bulwer published ‘Philocophus: or, the deafe and dumbe man’s friend’, which contained the following, and thought to be the first, description of lipreading in print:

 

‘Exhibiting the philosophicall verity of that subtile art, which may inable one with an observant eie, to heare what any man speaks by the moving of his lips.

 

‘that a man borne deafe and dumbe, may be taught to heare the sound of words with his eie, & thence learne to speake with his tongue.’

 

In 1680 Scottish intellectual George Dalgarno published ‘Didascalocophus, or the Deafe and Dumbe Man’s Tutor’, on methods of teaching the deaf.

 

Swiss physician, Johann Conrad Amman in 1692 published his book ‘Surdus Loquens’ in which he advocated getting the attention of his pupils to watch the motions of his lips and larynx while he spoke, and then inducing them to imitate these movements, until he brought them to repeat distinctly letters, syllables and words.

 

During the 1700s, people such as the Englishman Dr Henry Baker and Frenchman Jacob Pereira were evidently very interested in the process of lipreading and both had successes with their teachings, though unfortunately nothing is documented about their specific methods used.

 

In 1760 the Frenchman Charles Michel De L’Epee was the driving force behind opening the world’s first free school for the deaf. He is known as the Father of the Deaf and is seen as one of the founding fathers of deaf education.

 

It seemed then that deaf people, whether using sign language or being taught speech through lipreading methods had, throughout recorded history, some degree of access to education.

 

This state of being was shattered somewhat in 1880 at the Second International Congress on Education of the Deaf in Milan. The Milan Conference, organised and attended by hearing professionals who advocated oralism in deaf education, voted overwhelmingly in favour of oral methods being used over sign language and effectively banned sign language as a means to educate deaf people.

 

The outcome of the conference was certainly predetermined and of the 164 delegates, 163 were hearing and one was deaf. The wording of the resolutions to be passed left no doubt in the minds of the organisers what they felt about sign language.

 

Resolution One was passed 160 to 4. It read:

 

The Convention, considering the incontestable superiority of articulation over signs in restoring the deaf-mute to society and giving him a fuller knowledge of language, declares that the oral method should be preferred to that of signs in education and the instruction of deaf-mutes.

 

Resolution Two followed a similar pattern and was passed 150 to 16. It read:

 

The Convention, considering that the simultaneous use of articulation and signs has the disadvantage of injuring articulation and lip-reading and the precision of ideas, declares that the pure oral method should be preferred.

 

The conference changed the face of education for deaf people and now oralism and lipreading were given enormous prominence. By 1895 manuals to be used in deaf education were available. One such manual was written by Richard Elliott (who is believed to have voted against the two resolutions at the Milan conference). Elliott was the Headmaster of the Asylum for the Deaf and Dumb, Old Kent Road, Surrey, and Margate, Kent and his instruction manual was called ‘A series of lessons in articulation and lipreading: containing full instructions for teaching the various sounds of spoken language’.

 

The book is full of exercises designed to help a deaf pupil to attain speech and thus, ‘he is placed, in the way of receiving ordinary communications, as nearly on a level with his more highly endowed fellow creatures’. Lipreading in the manual is described as:

 

‘the art of reading the speech of others by the observation of the visible effects made by verbal utterance on the organs of speech and the muscles of the face’

 

Arguments are made in the manual for observing the motions of the muscles of the face as well as reading the lips, and also for speaking slowly and deliberately with pupils in the first instance to build up their capacity for recognising facial movement that could later be transferred to follow natural rhythms of speech.

 

Hand mirrors are advised as a training tool, not to follow speech as such, but to observe how the mouth and face moves when saying particular words. Tissue paper too is used, such as can be blown by the pupil’s mouth when held near it and voicing certain words, thus helping him to recognise the different mouth movements related to different sounds.

 

The ultimate aim of the manual is, ‘to put the unfortunate deaf-mute in possession of the inestimable faculty of speech’.

 

Into the 1900s, as lipreading and the oral method of teaching deaf pupils continued, there were other pertinent happenings regarding deaf people.

 

In 1902 Jane Addams, a social activist of the time, wrote the book ‘Democracy and Social Ethics’ of which Edward Bartlett Nitchie said, ‘I have read no book in years that set out so forcibly the absolute necessity of ‘putting ourselves in the other fellow’s place’’

 

Nitchie was founder of the New York School for the Hard of Hearing and in 1912 he wrote the book ‘Lipreading: Principles and Practice’.

Front cover of Edward B Nitchie’s Lipreading Principles and Practise Publication

The book shares examples of his basic philosophy and the expectations of lipreading in paragraphs such as ‘watch the mouth of anyone who is speaking, and you will see many clearly defined movements of the lips, perhaps even of the tongue. The eye trained to associate certain movements with certain sounds has the power of interpreting these movements into words and sentences’ and goes on to say, ‘inability to hear spoken language is a calamity, unless other means than the ear can be found to convey the message to the brain’

 

Nitchie contends that training the mind as part of lipreading tuition is a more important factor than training the eyes. The eyes need to overcome the obscurity of movement of the lips and also to overcome the rapidity of such movement. He suggests that one-twelfth to one-thirteenth of a second is the average time per movement in ordinary speech. His belief was that lipreading should be studied by sentences rather than by single words and that, ‘the eye should be trained from the first to see things as they must always be seen in ordinary speech, and that is rapidly’.

 

Nitchie states that, ‘although it is not possible for the eye to see each and every movement, it is possible for the mind to grasp a complete impression without even the consciousness that it has “supplied” so many of the movements and sounds’. He tells us that thought is quicker than speech and that thought skips, looks ahead and anticipates. ‘So that a correct understanding of an idea is possible without word-for-word accuracy’.

 

He goes on to say: ‘The method of mind-training should aim to develop this power of grasping thoughts as wholes, and to avoid strictly anything that will enhance the opposite tendency of demanding verbal accuracy before anything is understood at all’, and that, ‘it is by developing these powers that real success in lipreading can be attained’.

 

Nitchie does not try to categorically answer the question of what can be attained from undertaking lipreading tuition, but does state that three lessons a week for three months will, with most pupils, give ‘a very satisfactory and practical skill’.

He later states that, ‘lipreading can never do all that good ears ought to do, but what it can do is almost a miracle’.

 

Nitchie’s three-pronged approach to teaching covered the three sides he believed everyone to possess: the physical, the mental and the spiritual. He divided this teaching approach into the following.

 

The Eyes (physical) must be trained:

 

a) To be accurate

b) To be quick

c) To retain visual impressions

d) To do their work subconsciously

 

The Mind must be trained to develop:

 

a) Synthetic ability

b) Intuition

c) Quickness

d) Alertness

 

The Spiritual springs of human life are more complex to achieve, though Nitchie suggests that many deaf people – to varying degrees – are ‘hungry’ for real conversation and feel ‘lonely’ though surrounded by friends and family. The counter to this is to instil an ‘I can’ and ‘I will’ attitude in place of ‘Oh! I can’t’ through offering sympathy of the right kind, offering a helping hand on the road to cheer and courage, giving the pupil a metaphorical slap on the back, meeting every mood of discouragement with cheer and hope, holding up the bright side of the picture always and encouraging by example of what others have achieved.

 

With so much information available about lipreading and, in Britain in 1911, when the National Bureau for Promoting the General Welfare of the Deaf (the forerunner to today’s Action on hearing loss) was first established, it seemed that services, publications and people were sufficiently in place across nations to cater for the communication and social needs of deaf and hard of hearing people.

Lipreading Tuition During WW1

 

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 servicemen 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.

Mock assessment of a young man being accepted into the army under questioning from a sergeant.

 

Many thanks to John Sadler for undertaking the role of sergeant and also to Alan Fidler (WW1 Commemoration Project) for his support during our project.

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.

 

Meanwhile in France, a pamphlet by EJ Moure and P Pietri printed 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 serviceman – 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.

Examples of Banjo hearing aids courtesy of Thackray Museum, Leeds

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.

Image: James Dundas-Grant

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.

 

Test Two

 

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.

 

Test Three

 

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.

 

Test Four

 

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’

Lipreading instruction being given to deafened soldiers and sailors in London

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:

 

Perfect 37

Very Good 10

Good 11

Fairly Good 5

Mediocre 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:

 

Entirely satisfactory.

(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)

 

Satisfactory.

(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)

 

Fair.

(cases are able to respond to simple sentences only, and require questions to be repeated from three to five times before they apprehend rightly)

 

Unsatisfactory.

(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

Satisfactory 1

Fair 4

Unsatisfactory 2

Unclassified 4

 

From 20 men assessed midway through the full-time day course the results were:

 

Entirely satisfactory 3

Satisfactory 4

Fair 11

Unsatisfactory 2

 

From 35 men who attended the evening classes the results were:

 

Entirely satisfactory 19

Satisfactory 5

Fairly satisfactory 2

Unsatisfactory 0

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

5 remained

 

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.

Group members utilising Speech To Text to access a talk about hearing aid devices at the Thackray Medical Museum by the Museum’s Laura Sellers.

Lipreading after WW1

 

In 1919 the publication The Disabled Soldier declared that, ‘Deafness is really more an embarrassment than a physical handicap’. It went on to suggest that, ‘the chief aim in treating the returned soldier who has been deafened in battle is to restore his capacity for mingling and communicating with his friends and business associates with the least possible embarrassment to himself or to them’, and that, ‘the best way to help the deafened soldier is by teaching him lipreading’. ‘Once he acquires skill in reading the lips’, it declared, ‘he becomes again a social being, cheerful and confident’.

 

In Mary B Stormonth’s Manual of Lipreading, published also in 1919, this suggestion of the expectations of acquiring lipreading and the limitations of the skill were revised in the preface (written by the deafened Marquess Of Graham) to, ‘by assiduous study of the facial muscles and lips, a deaf person can maintain an ordinary conversation’, and that, ‘for everyday use lipreading can and will enable a deaf person to avoid innumerable awkward situations’.

 

The Manual of Lipreading is fundamentally an instruction book, intended as a tool to be used between a teacher (who might be a friend or family member as well as a professional) and a deaf person. The teacher is encouraged to speak naturally, preferably without voice or at least speak very softly, using graphic little asides of movement and expression to help convey any meaning that is difficult to catch.

 

There is no longer a sole focus on teaching lipreading to deafened servicemen as the book is aimed at family members, older deafened people and deaf children. The philosophy for teaching makes no distinction between degrees of deafness, saying that, ‘as soon as a person finds that his or her hearing is becoming dull, he should train his eyes to lipread’.

 

The book suggests that one hour of tuition is sufficient for a class lesson and that twenty to thirty minutes, repeated throughout the day, is best on a one-to-one basis. If at least one hundred hours of lipreading practice are undertaken in this way then, the book says, ‘a student should lipread very passably’. It suggests also that this passable lipreading stage can be reached within anything from a few months to a year or two. Here we see again the difficulty in trying to measure lipreading to any degree of satisfaction.

 

Also in March 1919 the National Bureau for Promoting the General Welfare of the Deaf proposed ‘that the Bureau shall take steps to safeguard the interests of the deaf and of the provision of deafness in the coming Ministry of Health’ and that a letter should be drafted to show the figures giving the destruction of ears going on at the present time and showing how easy the prevention of such destruction was . . . (and that) how such a Ministry (of Health) would be of the greatest benefit to the deaf.

 

Whether the interests of deaf people included the continuation of lipreading tuition is questionable, given the pressure on the national purse. By March 1922 the question of lipreading continuation for ex-servicemen was already being questioned in Nottingham. A report of the time read, ‘the lipreading classes held in Nottingham and Mansfield have afforded instruction to 173 ex-service men, and keen disappointment is felt at an intimation the Ministry of Pensions is likely to stop the grant’.

The likelihood is that deafened servicemen around the world were put under similar risk with funding for lipreading tuition, though these photographs of French soldiers around 1920 appear – for the moment – to show a relatively thriving lipreading class.

 

The formation of the first World Games for the deaf in 1924, for athletes who have a hearing loss of at least 55 decibels in the better ear, were an indication that deaf people were being given opportunities, though this movement had more to do with those using sign language than those relying on lipreading. This was a further indication of the separate path that deaf sign language users were on in comparison to deaf lipreaders.

 

Although hard of hearing clubs were formed around the country, it wasn’t until after WW2, and with the work predominantly of Richard Annand, that these were more structured into a national association of hard of hearing people. Similarly, parents of deaf children got together in 1944 to start the early work of the National Deaf Children’s Society.

 

If lipreading tuition was an integral part of any of these societies then it was not recorded as such in their histories, nor were lipreading classes yet under one umbrella organisation.

 

Technology was catching up quickly for deaf people and the first minicom demonstration happened in 1964, giving an early indication that deaf people were going to be able to communicate long distance with their hearing peers on an equal playing field.

Image of an early minicom/textphone device. The screen allows people to see what is being said when they cannot hear what is being said. Common abbreviations such as GA (Go ahead) and SK (Stopped keying) were developed to help with swifter communication.

In 1973, a BBC Horizon documentary called ‘The Curtain of Silence’ suggested strongly that deaf people were still a long way behind their hearing counterparts in any real sense of inclusion, remarking that, ‘some say to hear is our most precious gift’ and that ‘normal’ adults have no difficulty in hearing speech. This may have been merely the language of a time, but it distinctly indicated that a deaf person was viewed in some way as less than normal.

 

Lipreading was offered to both pre-school children and schoolchildren and was, within the programme, delivered by enthusiastic teachers using the mechanism of toys and games, either in one-to-one situations or in small classroom groups. As with the Manual of Lipreading, parents were encouraged to take over in the role of teacher to get as much input of lipreading and the rudiments of speech to the child as possible from a young age. One teacher was keen to point out that lipreading was not just looking at the lips, but involved the whole expression.

 

The purpose of such input the documentary informed us was to enable the child to, ‘understand the meaning behind flickering lips’, with the addition that, ‘only when the child can lipread . . will it begin to understand the importance of language and attempt to reply in words it will never hear’. Although it is quite shocking to hear a deaf child referred to as ‘it’ we can perhaps be lenient here and see the phrase as a whole attempting not to differentiate between genders.

 

The divide between lipreading and sign language seemed to be as great as ever, with sign language being described as ‘slow’ and fingerspelling referred to as, ‘compared to speech, it’s pathetically slow’. Speech was still evidently the ultimate goal for all.

 

The programme suggested that older deaf people are, ‘likely to be treated as stupid or an annoying embarrassment’.

 

In further strong language the programme went on to say, ‘In our loquacious society the deaf are linguistic lepers; rarely can we be bothered to make that little extra effort in talking to them, trying to understand them’.

 

The hearing aid technology shown is generally quite cumbersome, and though behind the ear hearing aids were available, they weren’t given as standard issue to deaf people through the NHS because of their perceived expense.

 

Other devices being tried and trialled during the programme were a minicom/text phone service, a finger pad device that enabled a deaf person to match vibrations to sound, and a device that recorded and displayed the natural rhythms of speech. Technology to aid deaf people was certainly on its way, though naturally there was a very wide scope between those things that worked and those which did not at this point in time.

 

The final, rather dispiriting, word in the documentary was left to the Chief Medical Officer of the NHS, Sir George Godber:

 

‘One of the most striking shortcomings in the clinical field is the inadequacy of our provision for the diagnosis, treatment and rehabilitation of the deaf’.

 

Later into the decade, the formation of ATLA (Association of Teachers of Lipreading to Adults) in 1977 was a positive step in bringing lipreading classes together under the banner of one organisation, with the belief that lipreading ‘belonged in education’.

 

This difficulty remains today in that, though lipreading can be taught, it cannot accurately be measured, in that there is no definitive test (given all the issues around communication, such as lighting, space between individuals, obstacles, tiredness, different teachers/assessors) to say whether someone has improved in their lipreading or by what degree they have improved. This means that an individual person can undertake lipreading tuition, funding permitting, for many years at a time, without any accurate measure of their progress or otherwise.

 

There were examples in our research group of lipreading tuition being offered as a foreign language course within adult education, which, by any definition, is not the right place for it. Why then could lipreading not be considered a health issue and be regarded as lipreading therapy, in the way that the development of speech has speech therapy? This would further emphasise the difference between lipreading tuition being undertaken as a means for a deaf child to develop speech, against a deafened or hard of hearing adult undertaking lipreading tuition to better read the lips of another person.

 

Into the 1990s the world of communication changed very dramatically, very quickly. Text (SMS), email and google searches appeared and were readily available to all. Society learned and decided the rules of these technologies together, whether deaf or hearing, and the communication field – at least as far as technology was concerned – was levelled. People could now contact each other across the globe in a way that had never been available before, and systems for alerts such as from banks and doctors were now accessible for all deafened people.

 

This upsurge in technology raised the question of whether the art of lipreading had now become less important or whether, even, it had become obsolete? Our group found emphatically that lipreading has not become obsolete, as people will always have a great need to directly communicate with each other, share ideas and enjoy one another’s company face-to-face, no matter how much technology offers us the tools to communicate in other ways.

 

In this new technological world lipreading has become difficult to define, searching for its place in learning, health and social situations. The very definition of the word has not so much developed with the times as become stifled by them. A recent definition uncovered by our group members read that lipreading can be defined as, ‘the correct identification of thoughts transmitted via the visual components of oral discourse’. A rather confusing way to say what a previous definition more accurately portrayed, ‘the art of understanding a speaker’s thoughts by watching the movements of his lips’.

 

Our own group, after much debate, came up with a lipreading definition as, ‘lipreading tries to bridge the gaps of hearing loss or deafness in conversation. This is via the method of reading lips, facial expressions, body language and knowing the context of the conversation’. It is as accurate and also as prone to being criticised as any other definition.

 

However we choose to define lipreading, we can observe what it has become and where it sits on our current society. In the adult world lipreading is no longer the intense, time limited, structured learning intended to get people back into their purposeful occupations by overcoming their deafness, as it was during and immediately after WW1. It has instead developed into the learning of a life skill, taken on board by a deafened person over an indeterminate length of time, within a weekly class (usually 1 – 2 hours duration) amongst people going through similar situations. The classes offer positive social connections with others and are generally led by tutors who can impart knowledge on other things connected with deaf people outside of lipreading tuition, such as on equipment, communication tactics and local deaf services.

 

Participants in classes are recorded as saying that attendance at lipreading tuition gives them confidence in work and social situations, which is today as valuable as reaching any specified target.

Local hearing therapist, Val Tait, delivering a modern day lipreading class to some of our project participants at our home base in the Linskill Centre, North Shields

In our modern world there has been a recent push for Sign Language to be taught as part of the school curriculum and locally Cued speech (a manual system of 8 handshapes in 4 positions near the mouth which clarify the lip-patterns of your speech) is a part of one school’s education. Lipreading has had its own push, via the 2018 Hear My Lips campaign, though it does not appear to have the same appeal as the more visual communications for schools and there is a rarity of younger hearing people interested in lipreading.

 

A more balanced campaign for deaf inclusion in schools would perhaps be via generic deaf awareness, including imparting knowledge and skills about the many, varied communication methods used by deaf people. Lipreading, it would seem, has not been given the priority it deserves, especially around joint partnerships, communities and inter-generational relationships.

 

Lipreading in the future is likely to be guided by changes and improvements in deafness. Cochlear implants have emerged as positive devices for many deaf people and hearing aid technology is developing all the time. But whether stem cell research leads to pioneering discoveries for deaf people, or whether computer based technological advancements, such as Watch, Attend and Spell (an artificial intelligence system developed to lip read 50% of speech), lead to fuller inclusion for deaf people, we must still guard against what lipreading alone is able to achieve.

 

A 2019 BBC drama, ‘Summer of Rockets’ (set in 1958) portrayed deafness and deaf characters very well. That was until the credibility of the programme was diminished when a young deaf girl, at a party, outside, in the evening, looking upwards towards a man standing on a platform about 15 feet above her and about 20 foot away, with his head turning to one side, lipread everything that he said perfectly. No-one can lipread as well as that under those circumstances.

 

There is an oft repeated question asked regularly of a deaf person and it is, ‘can you lipread?’. Saying yes to this question, even today, can leave the person asking the question with the impression that everything is okay, there is nothing to be done, lipreading will simply take the place of speech and the conversation will carry on just as if both parties were hearing. This is of course not the case. Lipreading has its limits.

 

A recent Employment Support Allowance (ESA)regulation regarding being treated as having limited capability for work-related activity lists as one of its many support group descriptors: ‘understanding communication by (1) verbal means (such as hearing or lipreading) alone’. The implication being that lipreading alone is on a par with hearing. It is not. It is a communication system that aims to help both deaf and hearing people.

 

In the 100 years since deafened servicemen were given lipreading tuition to overcome their deafness and be once again on a par with their hearing peers it seems, in some quarters at least, that what the function and understanding of what lipreading can attain has not come very far at all.