Chapter 24: The Ever-Changing Children

Beginning around 1941 and growing steadily, year by year, the incidence of blindness in babies rose to alarming heights, and no one knew why. Before the mystery was solved, between 10,000 and 12,000 children had been added to the blind population of the United States, their lack of sight due to an eye condition that had a name but neither a cure nor a known cause. The name was retrolental fibroplasia (which means a fibrous growth behind the eye's crystalline lens). No cure was ever devised, but the story of how the causative factor was eventually pinpointed and reversed adds up to one of medicine's most suspenseful detective stories, complete with innumerable false leads and an almost Holmesian solution.

The first genuine clue was discovered by Theodore L. Terry, M.D., professor of ophthalmology at Harvard Medical School. In a single year he saw 6 blind infants with this strange membraneous growth at the back of the eyeball, heard of 8 other cases, and made the significant observation that all 14 babies had been born prematurely. It was Dr. Terry who gave this eye condition its cumbersome name (it came to be called RLF for short) and who first described it in medical literature. The Texas-born physician with the clipped moustache and the thinning shock of red hair, whose brusqueness concealed a deep sensitivity, found it emotionally devastating to have to tell one set of parents after another that their babies were blind and that neither surgery nor medicine knew any way of correcting the condition. Prematurely born at birth weights under three pounds, these infants had been saved from death by relatively new medical techniques. Did blindness have to be the price they paid for survival?

Theodore Terry was a dedicated scientist as well as a humane physician. With financial help from James Edgar Pew, a Philadelphia industrialist whose grandson had been Terry's first RLF patient, he set up an organization, the Foundation for Vision, consisting of a team of medical researchers abetted by a group of specialists in child development and family counseling. The latter would work with the parents of the blind infants, helping them adjust to their personal traumas and offering practical counsel on how to bring up blind babies. The team's base of operations was the Massachusetts Eye and Ear Infirmary in Boston, but its members also traveled for research and consultation to the other large eastern cities where RLF had begun to appear.

One of the most mystifying aspects of the disease was the way its incidence varied in different localities, even in different hospitals in the same locality. Initially, only Boston seemed to be affected, but once Dr. Terry had published his first report in a medical journal, word of similar cases came from a few other cities. As the data began to be analyzed, another puzzling fact surfaced: for the most part, cases of retrolental fibroplasia were occurring only in the biggest and most sophisticated medical centers, hospitals that boasted the best in equipment and care. Virtually no cases were reported from rural or suburban hospitals.

Other medical researchers soon joined Dr. Terry's team in the hunt for causes. Were there variations in the way different doctors or different hospitals treated "preemies"? In 1947 a statistical and epidemiological study by biochemist V. Everett Kinsey and research anatomist Leona Zacharias tabulated existing variations and reported that one of several points on which pediatric care in hospitals differed was "frequency of use and duration of exposure to oxygen." They were on the threshold of a vital discovery, but no one recognized it at the time. Much more credence was given to other theories from various quarters.

Could the cause be too-early or too-sudden exposure to light? In one hospital a medical team blindfolded 33 premature infants as soon as they were born and kept their eyes shielded from light until they had gained enough weight to be ready for discharge. It made no difference; 15 of the 33 developed some degree of RLF. Was it lack of Vitamin A in infants born before full term? Large doses were administered, but the trail led nowhere. A Baltimore husband-and-wife medical team developed a theory about Vitamin E deficiency as a cause, but this theory, too, petered out after extensive trials. A researcher in St. Louis pointed a finger at oxygen insufficiency as the culprit; others thought the trouble might stem from the shock of sudden changes in the oxygen levels of the incubators in which the premature babies were kept until they reached normal birth weight. If RLF were a kind of withdrawal symptom, a more gradual transition might prevent it.

All these theories were pursued with urgency and skill, but none halted the tide. By 1951 the RLF epidemic was reaching new heights, and the spirits of the men and women working to counteract it were sinking to new lows. In April of that year 25 of the principal researchers met in New York City, acknowledged that no one had nailed down either cause or cure and determined to organize a permanent committee for continuing investigation. Dr. Terry had died of a heart attack in 1946; his successor at the Boston project, Dr. Kinsey, was named chairman of the new committee.

Within a year, the committee had some telling clues to follow. Not long before, a young resident in ophthalmology at the District of Columbia General Hospital had begun to make a statistical correlation of the incidence of retrolental fibroplasia with the number of days the affected babies had been kept in oxygenated incubators. He and his associates found enough correspondence in the two sets of data to start them on a small controlled experiment. Some premature infants were placed in the routine high-oxygen (60 to 70 percent concentration) atmosphere for a month or longer. With others, high-oxygen administration was reserved for those occasions when cyanosis or other symptoms of breathing difficulty developed. The physician who pursued this line of inquiry, Dr. Arnall Patz, later explained:

Cutting down on oxygen was much easier said than done. The night nurses were always turning it on again because they were so sure we were doing wrong. And it was a tough thing to sleep with, this business of keeping babies on low oxygen when all the teaching had been to give them plenty of it.

The results of this small study, which Dr. Patz published in September 1952, were strongly suggestive if not conclusive. In the high-oxygen group, 20 percent of the babies developed retrolental fibroplasia; in the low-oxygen group, the figure was less than 2 percent.

By that time similarly revealing hints were coming in from foreign sources. A pediatrician in Birmingham, England, became aware that her local hospital had never had a case of RLF until it replaced its leaky old incubators with airtight models. In Melbourne, Australia, another pediatrician made the same observation soon after her hospital installed its new, efficient "oxygen cots."

The aggregate number of cases from these diverse sources was too small to constitute real proof, but it was large enough to call for a major controlled study that might settle the issue once and for all. Such a study was begun in July 1953 under the joint sponsorship of the federal government's National Institute of Neurological Diseases and Blindness and two voluntary agencies. It called for simultaneous clinical trials in 18 cooperating hospitals. Each hospital would divide its caseload of low-weight premature infants into two randomly selected groups of uneven size. The smaller group would receive the standard high-oxygen treatment; the larger would be given oxygen only as needed. A total of 75 clinical investigators and 800 babies would participate.

Many of the cooperating doctors were dubious and uneasy, but within three months enough evidence was accumulated to show that the mortality rate among infants receiving oxygen only as needed was no higher than it was among those receiving the standard treatment. The ground rules of the clinical trials were promptly changed: all prematures would now be kept on restricted oxygen treatment.

Was this, finally, the solution? It took a while to know, since RLF often could not be diagnosed until the babies were several months old. But the proof, when it came, was overwhelming. Of the babies in the groups treated with routine high oxygen, 1 in 4 developed retrolental fibroplasia; of those in the groups given lower concentrations or intermittent treatment, the figure was 1 in 13. The mystery had been unraveled.

With the worldwide announcement of this discovery—the director of the National Institute of Neurological Diseases and Blindness called it "the most important single clinical advancement in ophthalmology during the past decade"—the epidemic tapered off sharply. But it did not quite come to a halt. Habitual routines proved hard to reverse. In many places Dr. Patz's experiences were duplicated. As one New York ophthalmologist remarked: "Everyone wanted to turn the oxygen on. … It was like giving a lollipop to the baby."

Faulty communications also played a part. Although hospitals, pediatricians, and medical schools were alerted, and articles appeared in major medical journals, a questionnaire sent out by the National Society for the Prevention of Blindness a year after the breakthrough discovery found 70 of 113 hospitals still routinely administering oxygen to all low-birthweight premature babies. In September 1955 the American Academy of Pediatrics issued a fact sheet beginning "The accumulated evidence definitely incriminates the excessive use of oxygen as a major factor in the cause of retrolental fibroplasia in premature infants" and recommending that oxygen, when administered, be in no higher concentration than 40 percent. Through a never-explained series of errors, the statement failed to be published in either the Academy's newsletter or its professional journal.

In areas like New York City, where public health officials took firm preventive measures, new cases of RLF showed a dramatic drop-off. Control mechanisms were introduced in the large medical centers whose airtight incubators had been responsible for the largest number of RLF cases. Most introduced such safeguards as using only tanks of premixed oxygen in concentrations no higher than 40 percent. But as the years went on and smaller hospitals in rural and suburban areas updated their pediatric equipment, sporadic new cases of RLF began to appear. The disease had become so rare, Dr. William Silverman said in 1968, "that most physicians lost interest because they saw so little of it."

What did attract medical interest at the time was infant death caused by the respiratory syndrome called hyaline membrane disease, for which the treatment was high oxygen administration. Once again doctors faced a difficult dilemma. Citing a 1967 survey which brought to light 33 new cases of retrolental fibroplasia, most of them incurred through treatment of premature infants for respiratory distress, Dr. Silverman warned that RLF, "the disease we thought had practically disappeared, is rearing its head once more." The accuracy of this warning was attested in 1972 when the parents of a four-year-old Connecticut child blinded by retrolental fibroplasia won a lawsuit for damages against the physicians who had treated the child at birth and the hospital where the oxygen overdose had been administered.

At the point where the medical profession could consider its end of the problem solved, a crisis point was being reached by those concerned with the thousands of young children already blinded by RLF. Keeping pace with the "baby boom" that followed the return of servicemen from World War II, the number of infants with retrolental fibroplasia peaked during the 1949–1953 period. New York State alone had 922 known cases in 1955; the children ranged in age from newborn to early teenage, with three out of four under six years of age.

Well before then, schools for the blind had begun to sense the upcoming demand. Residential schools in the epidemic areas initiated or expanded guidance services to parents of preschool blind children. They also began enlarging their facilities.

A "summer school" for mothers and their blind babies had been initiated in the Michigan School for the Blind in 1937 with good results, and a number of other schools decided on similar methods of parent counseling. Boston having been the hub of RLF discovery and concern, Perkins was the first to respond to the need for help. In the summer of 1945 it began a two-week institute at which the mothers of the RLF infants heard lectures by ophthalmologists, child psychiatrists, pediatricians, psychologists, and nursery school educators. They were given opportunity for individual consultations with these specialists and also observed the techniques used in a nursery school setup where their children, ranging in age from one to five years, were cared for. A collateral benefit was familiarization with the Perkins campus and facilities; many would be enrolling their children there in due course.

Overbrook, which began annual 12-day summer sessions of this type in 1949, soon found itself with a waiting list. It also prepared actively for the future by doubling its kindergarten facilities. On the West Coast, the Oregon school initiated annual summer institutes in 1949; with financial help from statewide fraternal bodies, it also started a successful program of placing blind preschool children in nursery schools with seeing children. The California school reported in 1953 that pupils under ten years of age already made up 40 percent of its population. Of greater significance was the fact that the number of blind children attending public schools in California had more than tripled in the preceding decade. Emotional support and guidance for parents were being supplied by a statewide program of visiting teachers.

Back in the east, Delaware, which had never established a state residential school, sending the majority of its blind children to public schools and the remainder to the nearby Maryland School for the Blind, coped with the emergency by setting up a special day nursery for blind infants; with virtually all of the state's RLF children concentrated in and around Wilmington, it was feasible to have them bussed to a single center. Funds to launch the nursery school were raised by public subscription in a 1950 campaign spearheaded by a parent group. Subsequent funding was taken over by the state commission for the blind.

The Connecticut School for the Blind reported in 1953 that its average enrollment had increased 50 percent in four years, and that the state had appropriated more than $500,000 to expand the school's facilities. The average entrance age, formerly nine, was now down to five; a greatly lengthened period of schooling was in view for the years ahead. A similar prospect was reported by Michigan, where the school had already had to increase its staff by three primary school teachers and two houseparents.

Most of these developments were recorded in the October 1953 issue of the Outlook, which printed a roundup of reports from various parts of the nation describing the impact of retrolental fibroplasia on educational facilities. Many schools had little to report. Located in areas not hit by the RLF epidemic, they were experiencing no pressure. Others were handicapped by the absence of hard data on which to base long-range planning. The latter problem was described by Robert H. Thompson of the Missouri school. How could intelligent planning take place without some accurate foreknowledge of demand? "We are torn between two dilemmas," Thompson wrote:

One dilemma is the erecting of buildings for an anticipated enrollment which we hope medical science will prevent from materializing—in which case we could have mostly white elephants on our hands and second guessers would criticize us for our folly. The other dilemma is to wait to build until the increased enrollments have materialized and penalize those who have urgent need of our services by the delayed availability of adequate educational facilities. Either choice is distasteful.

Although RLF cases were restricted to relatively few states, the bulges in the affected schools sent up the national totals of residential school enrollment from 5,014 in 1949 to 5,324 in 1953. The public school figures showed really startling changes—from 656 blind pupils in 1949 to nearly twice that many—1,214—in 1953. In both instances the quantum jump still lay in the future, for as of 1953 the majority of RLF children were still too young for school.

Once the shift to public schools began in earnest, there was no reversing it; from year to year an increasing proportion of the nation's blind children would now be living at home and attending schools in their communities. The proportion of blind children educated in public schools, for so many years a flat 10 percent, reached 18.6 percent in 1953; five years later it was 48 percent; by 1962 it had reached 57 percent, and in 1972 it was apparently stabilized at just over 60 percent.

Several factors shared responsibility for the changed picture. One of the most dominant was a matter of social class. Mostly from the urban middle class, the families of the RLF children valued independence and self-direction and were imbued with greater confidence in their ability to cope and overcome than had been the case with the majority of families of earlier generations of blind children.

The postwar social climate also had its influence. It was an era of growing activism on the part of parents whose children had any sort of physical or mental handicap. Some of the major national health organizations dealing with specific disease entities—cerebral palsy, multiple sclerosis, muscular dystrophy, cystic fibrosis, and the like—came into being during this period, most of them parent-instigated. One consequence of the pressures exerted by parent groups was that school authorities were compelled to recognize the claims of all kinds of handicapped children to educational opportunity.

Demographic factors came into play as well. Public school systems previously without enough demand to establish educational provisions for blind children were now confronted with sufficient numbers to warrant setting them up. The postwar migration to suburbia spurred construction of innumerable new schools, and the parents of blind children made strong demands that resources be provided for their education.

The question about the public school movement raised by George Oliphant back in 1910—"shall we sit still and see if it will run over us?"—finally had an answer. But the answer, as it emerged, did not generate as much heat as might have been expected. By and large, those who still held the most passionate convictions on either side of the residential-public school debate were holdovers from an earlier generation. The newer leaders in education were no longer so concerned with it.

What were the main points that had divided the opposing camps? Public school advocates accused the residential schools of regimenting children, of weaning them away from their homes and families, of instilling unrealistic career expectations, of failing to prepare them adequately for the rebuffs of society. Defenders of the residential school denied these allegations, cited the excellent academic achievements of their graduates, and leveled their own charges: day classes in public schools were so inadequately equipped and so largely staffed with inexperienced teachers that the children attending them received inferior educations; blind children in integrated programs got lost in large public school classes where teachers could not possibly give them the individual attention they needed; public schools did not provide the physical training, musical, and manual arts programs at which residential schools excelled; the social acceptance of blind children by their sighted schoolmates was nominal rather than actual; blind children were largely excluded from the recreational and sports activities of the other students; blind children were needlessly indulged by both teachers and peers in matters of discipline and behavior.

The fair-minded among the educators recognized that most of these charges and countercharges had some validity, and sought to build bridges between the two forms of education so as to give blind children the best of both. One of the most useful forms of bridge-building was the practice, followed by the more progressive residential schools, of having their older students attend community high schools.

In earlier years such opportunities had been selectively granted to a handful of gifted students. First to adopt the practice on a general scale had been the New York State School at Batavia, the very institution whose cornerstone-laying ceremonies had been the scene of Howe's somber warnings against the evils of segregated education for blind children.

At the 1910 AAIB convention, Batavia reported success with sending its older students to a community high school. Among those who learned of the report was George F. Meyer, a sixteen-year-old boy just entering the ninth grade at the Washington State school for the blind. With the reluctant permission of the school's superintendent, he memorized the long walk to the nearest city, Vancouver, Washington, and enrolled in the local high school. But solving the travel problem was only the first step. As one of the colleagues associated with him in his later professional life told the George Meyer story:

The janitor and one of the partially-seeing boys read assignments to him late into the evenings in a furnace room—the only place in the school with light that late at night. They took turns dictating the Latin textbooks letter by letter since neither had studied Latin. George hand-transcribed his own books. He was valedictorian of the 1914 class of some sixty or seventy pupils of the Vancouver, Washington High School and went on to receive his Phi Beta Kappa key at the University of Washington.

Understandably, Meyer turned into a strong advocate of public school education for blind children. In the early Twenties he organized the first such classes in Minneapolis and in Seattle; returning to Minneapolis, he spent 15 years as supervisor of classes for the blind before moving east to become executive director of the New Jersey State Commission for the Blind in 1937.

New Jersey was the perfect place for him. It was one of the few populous states that had never organized a residential school for the blind and was therefore among the pioneers in day school education. The first public school class opened in Newark in 1911 at the initiative of Meyer's predecessor, an energetic and imaginative blind woman named Lydia Y. Hayes. She had organized the New Jersey commission in 1909 and was largely responsible for shaping the state's policy toward education of the blind. She began the practice of having the state pay for reader service for blind students, rallied a corps of volunteers to produce brailled textbooks, and thriftily saw to it that when one student finished a textbook, it was handed on to the next. Blind children in rural areas, where there was not enough demand to organize classes, were sent to residential schools in the neighboring states of New York or Pennsylvania but were encouraged to return home for their high school work. Education, it should be noted in adding up the considerable accomplishments of Lydia Hayes, was only one of the commissioner's responsibilities; she directed all of the state's tax-supported work for the blind, children and adults alike.

Soon after George Meyer took over the job on Miss Hayes' retirement, he launched a new service, the itinerant teaching program, which made it possible for blind children to attend local schools even in small and scattered communities. This program, started in 1943 with a single traveling teacher, was so soundly conceived and developed that it served as a model for other states when the day school movement began its spurt of nationwide growth a decade later.

Meyer, who remained in office until five years before his death in late 1969, was a firm believer in public school education as a realistic introduction to adulthood. He compared this day-to-day exposure to the blunt facts of life in a normal home with the attitude frequently found in a residential school child, who thought of himself as a visitor when he returned home during school vacations and, consciously or unconsciously, made unfavorable comparisons between his family's modest living environment and the facilities afforded by a well-equipped residential school. Moreover, the child's feeling of alienation from his family and his community was all too often reciprocated.

Meyer's views represented one extreme; at the other was Merle E. Frampton who, throughout his 35-year tenure as principal of the New York Institute for the Education of the Blind, assumed a defender-of-the-faith mantle in proclaiming the superiority of residential school education. Frampton's attitude was best summed up in the title of a pamphlet he wrote in the mid-Sixties: The Tragedy of Modern Day Education for the Blind as Practiced in the Integrated Public School Classes.

Twenty elements of the "tragedy" were cited. Most were the traditional criticisms, but a few were new and rather far-fetched, such as his comment that urban transportation arrangements were "inadequate, erratic, costly and destructive of an optimum education program. How can a child be ready for study in any school after one to two hours of travel in the early morning? … The blind child on school arrival is ready for bed, not a rigorous program of education."

Unchanged from the stance of a book he co-authored in 1953, the gravamen of the Frampton position was that "there cannot be two 'bests' in a method" and that schools which segregated blind children for educational purposes "provide the best system so far conceived."

Despite its occasionally exaggerated rhetoric, the Frampton defense was temperate compared with the slashing attack leveled at residential schools many years earlier by Dr. Thomas D. Cutsforth, an instructor in psychology at the University of Kansas. After losing his sight at the age of eleven, Cutsforth himself had attended the Oregon School for the Blind from 1905 to 1912. He went on to the University of Oregon where he earned his baccalaureate and master's degrees and taught psychology before beginning his doctoral research.

In The Blind in School and Society, a book based on the research which earned him his doctorate in 1930, Cutsforth charged that graduates of schools for the blind were "very deficient in sensory and motor functions" and that this was due to the educational philosophy which steeped them in "the traditions and content of a visual development that runs counter to their personalities and is alien to their perceptual processes." The book, which had a strong Freudian orientation at a time when this viewpoint had not gained much ground in any but avant-garde circles, also dealt with the fantasy life of blind individuals, with sex behavior, personality development, and social adjustments.

Many of Cutsforth's points would later be recognized as sound, but his language was so immoderate and his criticism so unsparing that publication of the book met with a hail of offended reactions. Even the gentle, objective, and scholarly S. C. Swift described the work as "ferociously frank … scornfully cynical." Cutsforth's weakness, Swift wrote, "lies in the unsoundness of his generalizations—notwithstanding the fact that his judgments are delivered with all the assurance of infallibility." Samuel P. Hayes, who pioneered in the psychological evaluation of blind children, also questioned the author's fairness in building his arguments solely on cases of extreme maladjustment.

There is no record of any reaction by Helen Keller, whom Cutsforth repeatedly cited as a conspicuous example of how what he called "the hypocrisy of verbalism" subverted true educational aims. Imposing a "visual superstructure" on a child who has never had vision, he claimed, "robs the sensory world of a wealth of beauty and appreciation and leaves in its place empty husks of visual meaninglessness." The literary tradition underlying education of the blind "produced an optimum condition for word-mindedness."

Eventually Cutsforth's book gained enough respect as a piece of original thinking to prompt the Foundation to republish it long after it had gone out of print. A new edition, augmented by a speech Cutsforth had made on "Blindness as an Adequate Expression of Anxiety," was issued in 1951. Cutsforth himself was by then living in Los Angeles and maintaining a private practice as a clinical psychologist. He retired in 1959 and died three years later.

Cutsforth, whose book originally appeared in 1933, dealt only with the residential schools; he totally ignored the public school classes which, at that time, were educating an insignificant fraction of the nation's blind children. Twenty years later this was no longer true, and responsible leaders were asking themselves how well prepared were these public school systems to handle their mounting responsibilities.

In the early Fifties there was no universal answer. Pockets of experience existed in various places, but no one had put them together into either a philosophic or methodological framework. A landmark step was the week-long National Work Session on the Education of the Blind with the Sighted, which was held in August 1953. Sponsored by the Foundation, the Pine Brook Conference (so called because it took place at a camp of that name in the Adirondack Mountains) engaged the energies of two dozen experts in general and special education. The report of its findings, issued the following year, came to be a bible of first principles based, as the foreword noted, on "realistic thinking, actual experience, and a firm belief in the educational rights and needs of the individual blind child."

The conferees identified three main patterns of public school education of blind children—the Cooperative Plan, the Integrated Plan, and the Itinerant Teacher Plan—and pinned down the specific elements needed to make each of them work effectively.

The Cooperative Plan was the latter-day descendant of the earliest form of public school education, the "braille classes," in which blind children received all of their schooling from a special teacher trained in education of the blind. These were segregated classes, essentially similar to those in the residential schools; the main difference was that the child continued to live at home. At the beginning, the braille classes embraced both totally blind and partially sighted children. It did not take long, however, for the fallacy of this practice to be noted and separate "sight-saving" rooms were set aside for those pupils who had enough vision to use large print as their reading medium.

As time went on, practices in both the braille classes and the sight-saving classes underwent modification. Their pupils were sent to regular classrooms for some subjects, returning to their special home rooms for others and for supplemental help with the studies they were pursuing alongside sighted classmates. The home room teachers, who were specialists in education of the blind, provided whatever aids were needed: brailled or recorded texts, arithmetic boards, tactual maps and globes for the blind children, and large-type texts, optical magnifiers, bulletin typewriters and the like for the partially sighted. Each child's educational progress was planned and directed by his specialist teacher, who worked closely with the teachers of the regular classes the child attended. Hence the term "cooperative plan."

The Integrated Plan represented a step toward bringing visually handicapped children into closer context with their sighted peers. The blind or partially sighted child was no longer enrolled in a special home room but in an open class, and educational responsibility for him rested with the school's regular faculty. The specialist teacher of the blind operated out of what was called a "resource room," which was stocked with tactile and low-vision instructional equipment. The children came to the resource room as needed; also, as needed, members of the school's faculty consulted the specialist teacher on adaptations of classroom methods that enabled the visually handicapped child to keep pace with his fellows.

Under the Itinerant Teacher Plan the specialist instructor did not serve a single school but covered an entire district through periodic visits for consultation with teachers whose classes included visually handicapped children. This traveling teacher also saw to it that such children were supplied with texts and study materials in the forms they could use. The Itinerant Teacher Plan was a viable system for school districts in rural areas, or in large cities where each of many schools enrolled a few blind children. It worked particularly well in the junior high and high schools, where students needed less day-to-day guidance.

A somewhat different version of the Itinerant Teacher Plan, involving an operating partnership between a residential school and a state public school system, was already in existence at the time of the Pine Brook Conference. The "Oregon Plan" had been initiated in 1945 by the Oregon School for the Blind and the state's Division of Special Education. Here the residential school served as a kind of diagnostic and preparation center for blind children, equipping them with basic reading, writing, and other learning skills and then placing them in their local public schools under the continuing supervision of an itinerant teacher. A unique feature was the residential school's readiness to take the child back, if need be, for a shorter or longer period of additional training, or for ophthalmological treatment. In essence the Oregon Plan was not too different from what Samuel Gridley Howe had proposed at Batavia nearly a century earlier. But it also had a forward-looking aspect, for it presaged the climate of change that eventually would bring residential schools and public school systems into closer tandem.

Whatever the plan, each depended for its effectiveness on the knowledge and skills of the specialized teacher and on that teacher's ability to convey basic techniques to the much larger groups of teachers who had not been trained to work with blind children. The Pine Brook report outlined detailed orientation programs for the non-specialist teacher and comprehensive preparation programs at the graduate level for specialist teachers of the blind. Presumably the conferees recognized that what they proposed was more a prescription for the future than an instant remedy. Throughout the Fifties, as children born in the postwar population explosion began reaching school age, the nation faced a shortage of all types of teachers, but the shortage of those professionally qualified to work with blind children was particularly acute.

It was not a new phenomenon.

For the greater part of a century, teachers of the blind, whether in the residential schools or in the early public school classes, had acquired their skills through what was basically an apprenticeship. Many had no more than a high school education; motivation and adaptability were the characteristics sought by heads of schools for the blind. Many of those taken on as teachers were themselves graduates of the school. A few had gone through normal school and fewer still were college graduates. Actual teaching experience was a rarity.

Striving to have their schools recognized as educational facilities rather than institutions, the more progressive leaders in education of the blind were aware that qualified faculty was a prerequisite. In 1921 Edward Allen took an important step toward professionalization by establishing the Harvard Course on Education of the Blind. A six-month program operated in cooperation with Perkins by the Harvard Graduate School of Education, it earned its students credits toward a master's degree. Beginning in 1925, the course was supplemented by a second half-year program—the Special Method Course, in which the students underwent a residential apprenticeship at Perkins, attending lectures, observing classes and practice-teaching. Completion of this second unit, which was given under the direction of Jessica Langworth of the Perkins faculty, also earned graduate credits.

The same year that this twelve-month program began in Boston, a six-week summer course was initiated by I. S. Wampler, superintendent of the Tennessee School for the Blind, in a cooperative arrangement with George Peabody College for Teachers in Nashville. Those attending lived at the Tennessee School while taking instruction at Peabody from Wampler and the visiting faculty he assembled.

The two pioneer teacher training programs served different populations. The Harvard course attracted mainly newly graduated college or normal school students preparing for a career; the Nashville summer sessions were attended mostly by teachers already in service who were giving up part of their summer vacations. For various reasons, mainly financial, the Peabody program lapsed in 1928. It was revived for a single summer in 1931, but depression conditions made it a hardship for teachers to afford even the modest costs: $7 a week for room, board, and laundry ("a reasonable number of pieces," read the 1931 prospectus) and tuition at $4 per credit hour. The course was reinstated in 1935, with the help of a one-time grant from the American Foundation for the Blind.

During the same period that Allen and Wampler were striving to improve the skills of teachers in schools and classes for the blind, attempts were being made to introduce some orientation to blindness into general teacher preparation programs. The first such effort reportedly took place on the West Coast immediately after World War I when Dr. Richard S. French, principal of the California School for the Blind, and Dr. Newel Perry, his head teacher, served as lecturers in special education at the University of California. For several summers in the early Twenties, Robert Irwin held a similar post at Teachers College, Columbia University. In 1935 a more formal program was instituted at Columbia by Merle Frampton. It took the form of graduate scholarships, combining full-time study at the university with residence, proctorial and teaching duties at the New York Institute for the Education of the Blind. When the arrangement terminated in 1944, Teachers College asked the Foundation for help in restructuring its program and Berthold Lowenfeld accepted the post of lecturer in special education to fill the gap. The New York Institute's teacher training program was subsequently moved to Hunter College. Perkins, too, later transferred its course; it was moved from Harvard to Boston University in 1953.

As scanty as were the efforts to build a corps of professionally trained educators in all schools for blind children, the situation in the schools for Negro children was infinitely worse. Racial segregation not only kept black children in separate schools staffed by black teachers, but prevented those teachers from attending courses given at white southern colleges such as Peabody. Few earned enough to afford the expense of traveling to the non-segregated northern educational institutions which offered summer programs in special education.

One of the first assignments undertaken by Philip C. Potts when he joined the staff of the Foundation in 1937 was a survey of Negro schools for the blind, most of which were combined with schools for the deaf. His findings revealed such a need and hunger for training on the part of teachers in these schools that the Foundation moved to establish a pilot summer training program at a southern Negro college. The first such course was held in 1939 at West Virginia State College with the Foundation contributing Potts' time plus a modest grant to cover expenses for materials and to provide scholarships for some of the teachers who could not even manage the carfare from their homes to West Virginia.

The effort was so successful that the Foundation underwrote it for 14 successive summers. In 1942 the program was moved from West Virginia State to the Hampton Institute in Virginia, where completion of the eight-week session earned credits toward a graduate degree.

Practical results were seen almost immediately. In 1942 Robert Irwin wrote Mrs. Andrew Carnegie that "already in some of the southern states almost the entire staff of the school for the [Negro] blind is composed of teachers who have taken our summer school course." He did not mention, as he might have, that the project was the first and only one of its kind in the nation, and that it had already had a ripple effect that went beyond schools for blind children. With the help of credits earned through this course, one blind man who had been working in a broom shop became a professor in a southern Negro college; another obtained a teaching position in a state school; two others qualified for civil service appointments in public schools and still another obtained a Rosenwald fellowship for advanced study.

During most of the Forties Potts also directed a summer graduate course for teachers of the blind in the Department of Education of the University of Wisconsin, while Lowenfeld gave a similar course at the College of Education of the University of Washington. The same period also saw the Foundation heavily involved in sponsoring courses for home teachers at a number of colleges and universities, and, in cooperation with Perkins, giving a summer course for teachers of deaf-blind children at Michigan State Normal College.

There was one other key element in professionalizing the teaching of blind children that owed much to P. C. Potts. He headed a committee appointed by the AAIB in 1932 to consider the question of teacher qualifications; it was this committee that developed the three-level plan instituted by the Association for certification of teachers in schools and classes for the blind.

AAIB's teacher certification program was officially adopted in 1938 and the first awards made at its 1940 convention. By 1948, a total of 275 certificates had been issued. One explanation for the modesty of this figure was that even though the plan contained grandfather clauses which permitted the substitution of experience for academic credentials, many of the blind teachers working in the schools did not and could not measure up to certificate requirements.

It was Neal F. Quimby, superintendent of the New Mexico School for the Blind, who ventured to grasp this nettle in public. In a 1949 address to the AAWB—an address he prefaced by predicting that his comments would displease many in the audience—he spelled out his charges. Too many blind teachers, he said, were apt to "trade on their handicaps as an excuse for poor work," to exhibit emotional instability in reacting to criticism, to either resist all change or, at the other extreme, entertain radical notions for change, to harbor "an exaggerated idea of their real abilities." Quimby, who had spent 14 years as principal at Overbrook before moving to the New Mexico superintendency, acknowledged the distinctive assets that blind teachers could bring to their work but decried the inbreeding resulting from the desire "to look after our own" that led many schools to recruit teachers mainly from the ranks of their graduates. He blamed this practice, plus poor vocational counseling, for clogging the schools with people better suited to other occupations.

Coming as they did when educators of the blind already knew of 6,000 newly blinded infants, Quimby's remarks were timely. A problem of unknown proportions clearly loomed ahead, and those conscientiously concerned over education of the rising generation of blind children had to get ready as best they could.

"The time is not far distant," Quimby also warned, "when we will require equal intelligence and training for those responsible for the children out of school hours as we do for those who work with them in the classroom." He was speaking primarily of the residential school houseparents. With schools accepting pupils at earlier and earlier ages, the role of these adults as friends, confidants and surrogate parents was one of steadily growing importance. Recognition of their influence led the Foundation, beginning in the mid-Fifties, to stage a series of regional institutes for houseparents, designed to effect a closer partnership between them and teachers, social workers, and other professional personnel in the residential schools.

By 1954, when the tide of newly blinded babies was finally ebbing, it became possible to make a realistic projection of future manpower needs in education. A study made that year under the joint sponsorship of the Southern Regional Education Board, Peabody College, and the Foundation recommended adoption of a regional plan for teacher preparation, covering 16 southern states. Under this plan, Peabody would establish a year-round training program for teachers of visually handicapped children. The program would be launched with sufficient financial support from the Foundation to support a full-time professorship, five graduate training fellowships a year, plus a number of summer school scholarships.

The Peabody program got under way in 1957, with Samuel C. Ashcroft, formerly director of educational research for the American Printing House for the Blind, as its director. The Foundation's commitment was for $50,000 over a three-year period; subsequent financing was to come from the 16 states represented in the Southern Regional Education Board. When these funds failed to materialize in sufficient degree, money for two additional years of support was voted by the Foundation.

The regional teacher training program at Peabody was expected to be the first of a number of such regional centers strategically located across the nation. The thinking was that they would replace the hit-or-miss system under which schools for the blind had to rely on nearby colleges or universities for summer training courses. As things worked out, the regional center plan proved needless. In October 1963 the passage of Public Law 88-164 expanded earlier provisions for federal support in the education of certain categories of handicapped children to embrace a wider range of disabilities, of which blindness was one. Under this law an appropriation of just under $500,000 became available to finance 14 training centers for teachers of the blind. Subsequent federal legislation further enlarged the depth and scope of support for the education of the handicapped. In 1972 professional undergraduate and graduate preparation programs for teachers of the visually handicapped existed in 27 colleges and universities in 17 states.

The early decades of the twentieth century were periods of lively ferment in educational theory. What was the real purpose of education? How and why did children learn? Traditional educational methods had been keyed to the idea that the purpose of schooling was to inculcate habits of mental discipline that prepared children for adult life. No, said John Dewey among others, education is not merely a pre-game warmup, it is the game itself. Children were not adults in miniature, they had their own sets of values, their own realities, and education should acknowledge and build on these by working with "the whole child." Progressive education, the term given to this new approach, encouraged children to pursue their own interests, wherever they led, rather than having them squeezed into precast courses of study. Learning by doing instead of learning by rote was seen as the highroad to sound intellectual growth.

This new thinking was not lost on educators of blind children. As early as 1918 Thomas S. McAloney, then superintendent of the Western Pennsylvania School for the Blind, devoted his presidential address at that year's AAIB convention to the "new education" and how it affected schools for the blind. Every educator knew that blind children, like all others, were distributed along the entire intelligence curve from dull to gifted. Therefore, said McAloney, "we should have different standards for different mentalities, and … each individual should be studied and standards set for him."

How could these different mentalities be evaluated? A teacher's classroom observations might well be subjective. A more objective tool was the newly emerging science of psychology. Even as McAloney spoke, two schools for the blind were already applying its techniques to measuring the intellectual capacities of pupils. One of these was the Philadelphia school where, in the fall of 1916, Principal Olin H. Burritt had instituted a Department of Psychological Research with four closely related aims. As detailed by the department's director, these were:

1. To develop and apply methods for testing the mentality of pupils in schools for the blind; 2. To apply the technique of experimental psychology to some of the problems in the psychology of the blind; 3. To adapt to the blind some of the standard tests of school subjects now so widely used upon the sighted, and if possible, to suggest improvements in the pedagogy of the blind; 4. To work towards a method of vocational guidance through the use of mental tests of various sorts.

Burritt's initiative introduced into work for the blind a new personality, Samuel P. Hayes, Ph.D., whose name was to become part of the working vocabulary of all educators of the blind for the next half century. Hayes, a professor of psychology at Mount Holyoke College, had been referred to Burritt by Dr. Henry H. Goddard, head of the New Jersey Training School for the Feeble Minded at Vineland. One of the several psychologists who had worked out an American version of the Binet-Simon intelligence scales, Goddard already knew something of the problems in testing blind children. As noted in an earlier chapter, Robert Irwin had spent the summer of 1914 at Vineland, working with him on a version of the IQ protocols that replaced vision-related items with tactual or oral tests. Although Irwin's efforts failed to produce usable results, his collaboration with Goddard bore fruit when Burritt asked for help in introducing psychological testing at Overbrook.

Goddard mentioned this request in a talk to a group of psychologists. Among them was the thirty-one-year-old Hayes, who had earned his doctorate in psychology at Cornell University with a dissertation on color blindness. The idea of working with real blindness intrigued him. He accepted the part-time post of directing psychological research at the Philadelphia school and took a half-year's leave of absence from Mount Holyoke to live at Overbrook and gain a firsthand knowledge of blind children and the methods of educating them. He also assigned one of the graduates of his Mount Holyoke course to work full-time at the school.

Hayes was a slightly built man whose looks and manner suggested a kindly clergyman (a career he had once considered) or an absent-minded scholar. But the impression was deceptive. He was a prodigious worker and a prolific writer who continued to teach at Mount Holyoke until he retired in 1940 at the age of sixty-five. He lived another 18 years after that, professionally active until the end.

At about the same time psychological work was begun at Overbrook, Perkins employed a Vassar College graduate to administer intelligence and achievement tests to its student body. In 1918 the two schools decided to join forces by having Hayes divide his consulting time between them. At this point Hayes engaged one of the brightest of that year's Mount Holyoke graduates, Kathryn Maxfield, to take over the work at Perkins under his supervision. He also added a second assistant at Overbrook. In describing these arrangements to the AAWB in 1919 Hayes made clear that:

The use in schools for the blind of standardized tests of school subjects is still in its first or experimental stage. … Undoubtedly the standards will not be the same as those for sighted pupils, and it may take a considerable time before it will be safe to set standards for blind pupils.

He was to spend his entire professional life refining and revising these tests, trying them out in first a handful, and then a broad range, of schools and classes until, by the late 1940s, he was reasonably satisfied he had gone about as far as he could in working out instruments comparable to those used in measuring the intelligence or achievement of sighted children.

There were any number of obstacles, large and small, to be overcome. For one thing, the generalized IQ and achievement scales were constantly being revised and new psychological tests, such as the Wechsler-Bellevue batteries, brought into use. For another, the schools and classes for the blind contained children with a wide range of visual handicap, from total blindness to near-normal sight; tests for the partially sighted could not be the same as those for the children who could see nothing. Evaluation of test results also had to take into account the age of onset of blindness. A congenitally blind twelve-year-old boy, educated in finger-reading from the beginning, might well do better on a brailled test than a boy of the same age and mental capacity who had been blind a relatively short time and was not yet at home with braille. Oral administration of tests was one way of equalizing this.

The testing techniques themselves had to be made foolproof. For example, as Hayes once explained, in a true-false test in which the children used braille slates to record their answers, it was quickly discovered that

we must not let pupils write t for true and f for false on their braille slates because the braille t requires four dots while f requires only three, so the slower or less capable pupils have only to listen to the clicks made by the best pupils and write the same letters themselves.

A way out was found by instructing the children to use c for correct and i for incorrect, since both were two-click letters.

Consistently validated over a period of more than two decades, Hayes' findings were essentially that, in the better schools for the blind,

pupils test up to the seeing standards grade for grade. We cannot say that their educational achievement is equal to that of the seeing, for in most grades the blind tend to be about two years older, partly due to later entrance into school and partly as a result of the time consuming process of education through the fingers.

He also found that in the administration of verbal intelligence and school achievement tests, blind children needed more than twice as much time as the sighted because braille was a slower reading medium than inkprint. The substitution of oral examinations likewise slowed down the testing process.

Hayes made many efforts to work out ways of testing non-verbal areas, such as motor skills or manual aptitudes, but he did not get far, nor did he have much better luck with tests designed to yield personality profiles or vocational interest inventories. It remained for the next generation of psychologists to tackle these problems, with varying degrees of success.

Prominent in this second echelon was Mary K. Bauman, who developed a set of manual dexterity tests for blind persons during World War II. As director of psychometric work at Philadelphia's Trainee Acceptance Center, an organization which guided applicants for defense work into the training programs and industrial jobs they were best suited for, she discovered that no usable instrument existed that could test blind persons for manual or mechanical skills. She proceeded to develop her own adaptations of the performance tests used with sighted persons and tried them out with a group of blind volunteers. These were the first of many contributions Mrs. Bauman made to the development of non-verbal psychological evaluation instruments for visually handicapped people. Her increasing interest in the subject led to her establishing a psychological testing and vocational guidance service for blind persons. She gave this up in 1968 to become executive secretary of the Association for the Education of the Visually Handicapped (AEVH, formerly AAIB).

In a retrospective review published in 1972, Mary Bauman made it clear that much remained to be done in perfecting reliable performance tests for blind persons:

Psychologists and educators alike recognize that ability takes both verbal and non-verbal forms and that to measure only one of these is to measure only half of the individual's potential. … [Most of the non-verbal tests] which have been developed are inadequately normed, poorly validated, and lack that body of interpretative data which could make them useful to the many psychologists who see only a few blind persons each year. … we know little more about the performance ability of blind people than we did in the 1930's.

As keen as were educators of the blind to use the tools of psychology for assessment of student potential, they were even more concerned with how this new science could help improve teaching content and methodology. Robert Irwin was among those who had firm convictions on the pressing need for research in educational methods. A year after the Foundation opened its offices he hired Samuel Hayes' protégé, Kathryn Maxfield, as the staff educational psychologist and assigned as her first project a study of braille reading and how it was taught. Three monographs by Miss Maxfield in as many years culminated in a basic teacher's manual, The Blind Child and His Reading, published in 1927, and in the decision to link future research more closely to actual practice. This was accomplished by means of an "experimental school" project, jointly sponsored by the Foundation and Perkins, in which the latter's primary grades served as a laboratory for testing new approaches.

With Kathryn Maxfield as overall supervisor and Dr. Frieda Kiefer (she became Mrs. Ralph Merry soon thereafter) as resident director at Perkins, the experimental school, known as the Department of Special Studies, began in the autumn of 1927. Following up on the braille reading study, one of the initial experiments tested the relative merits of teaching beginners to write braille with traditional slate and stylus as against teaching them the use of the mechanical braillewriter. Other experiments tried out the teaching of reading by the word method, differing approaches to arithmetic instruction, various classroom seating arrangements and a "project teaching" approach to nature study. In addition, some individual psychological studies were pursued. Diagnostic workups were made of children with learning or behavior problems, followed by remedial programs designed to help.

As the project's findings emerged, reports were issued for consideration by other schools for the blind. A major medium for this material was the Teachers Forum, a bimonthly periodical initiated by the Foundation in 1928 as a vehicle for exchange of news and experience in educational methods. Kathryn Maxfield served as its founding editor; Samuel P. Hayes was a steady contributor of articles dealing with psychological work; faculty members of various schools wrote on curriculum development and teaching techniques; and the editorial content gradually broadened its scope to cover a range of collateral issues.

The Teachers Forum, which was one element in the Foundation-Perkins partnership, continued for a number of years after joint sponsorship of the experimental school came to an end in 1932. "It is the intention of Perkins to turn the whole Institution into an experimental and demonstration school," read one official explanation in the Teachers Forum of September 1932. "To our regret this valuable work will be discontinued … owing to lack of funds," read another official explanation, this one in the Foundation's annual report for 1932. Neither told the whole story. A more revealing glimpse was given by President Migel in his report to the Foundation board at its 1932 annual meeting: "Recently the newly appointed director of Perkins Institution has expressed a desire to continue this work independently of the Foundation, and has employed our former Educational Psychologist to direct this and other work connected with his school."

Back of all these explanations lay an administrative upheaval at Perkins that for months on end had been the subject of agitated talk and rumors throughout the field of work for the blind.

In mid-1931, much against his will, Edward E. Allen was retired from the directorship of Perkins and replaced by the Reverend Gabriel Farrell, rector of the Protestant Episcopal Church of Rhinebeck, New York, who was a stranger to both education and work for the blind. Allen's colleagues and the large body of blind people who had been his students during his more than forty years of educational leadership were scandalized by the peremptory manner in which he was removed from office just one year before Perkins was to observe its centennial and Allen himself to complete a quarter century of directorship of the school. On less personal grounds, the protests centered around the choice of a non-educator to head the nation's most prestigious school for the blind at a time when all such schools were striving for professional recognition in the field of education.

Proper Bostonians that they were, the Perkins trustees refrained from public response to a flood of private and published scoldings. Had they cared to, they could well have made out a reasonable case for their actions. Allen was seventy years old; for well over a year he had been urged, first informally and then by official committee action, to prepare for retirement by finding and training an understudy. But he had dragged his heels, unable to settle on a candidate he considered qualified. In a scrapbook assembled by his wife, documenting the circumstances of his retirement, one may find not only the innumerable letters from admirers which, she wrote, "kept his heart from breaking during this most trying experience of his otherwise happy and unclouded life," but also some of his correspondence with the Perkins trustees. Reading between the lines makes it apparent that Allen had suffered from ill health for some years, and that this had affected his work. In a memorandum sent to the trustees in January 1931 he noted that when their committee had formally notified him in the summer of 1930 that he should get ready to retire, he was "stunned" but acquiesced. However, he added, "I did not tell them that having finally learned to overcome my insomnia I was then feeling like my old self again."

At the time he submitted this memorandum, in which he reviewed the accomplishments of his administration—"Perkins as it is now is largely my own creation"—he was pleading to be given additional time to hand over the reins to a successor. The trustees, however, wanted the new director to take full charge at once. When Allen resisted, they moved ahead without consulting him further. He was given a pension and the title of director emeritus to become effective with his formal retirement at the end of June 1931.

Once the initial shock wave receded, Edward Allen's friends turned to salvaging his ego. At the end of April he was made guest of honor at the dinner jointly given by M. C. Migel and William Nelson Cromwell to wind up the World Conference on Work for the Blind. Olin Burritt had already written Migel in February suggesting "the extreme desirability of the Foundation taking active steps immediately to invite Dr. Allen to accept an official relation to the Foundation," specifically as a regular contributor to the Outlook and the Teachers Forum on topics "on which he is probably better qualified to speak than anyone else in the United States." Thereafter Allen's byline was to be found on many feature articles in the Outlook and in every issue of the Teachers Forum, where he conducted a largely reminiscent column, "Dr. Allen Says."

Other honors followed. The Perkins Alumni Association and its student body petitioned the trustees to name the school's chapel for him and there were suitable dedicatory ceremonies. When it met that summer, the AAWB adopted a laudatory resolution praising Allen's accomplishments; some years later it presented him with its Shotwell Award. Probably more meaningful to him at the time of the crisis was another resolution adopted at the AAWB's 1931 convention declaring

that boards of trustees when appointing heads of schools and institutions for the education of the blind … should place in charge of such schools and institutions only professional educators, and, when possible, those who are trained and experienced in the special work of educating the blind, and … that failure to live up to such principles on the part of boards of trustees … is to fail seriously in the performance of their higher duties and to place other interests before the welfare of the blind themselves and the welfare of society.

To Gabriel Farrell, who met his future colleagues for the first time at that very meeting, the adoption of the resolution hardly constituted a cordial welcome. But wiser heads among the confraternity recognized the futility of fighting a fait accompli; it was reportedly John F. Bledsoe of the Maryland School who led the way in breaking what amounted to a silent boycott and helping the newcomer feel at home.

Within a few years, Farrell made it on his own. During the two decades he was the Perkins director, he instituted many important administrative and program changes that won the respect of his fellow school heads. He was also astute enough not to repeat Allen's mistake of failing to groom a successor. When he retired in 1951, the directorship went to Edward J. Waterhouse, who had been with the school for 14 years, first as a teacher and then as head of the school's manufacturing affiliate, Howe Press. Waterhouse, too, was careful to train an understudy; when his turn came to retire in 1971, there was a smooth transition to Benjamin F. Smith. Smith, Perkins' sixth director and the first blind man to occupy the post, had started as dean of boys 20 years earlier and had been promoted successively to principal and assistant director before moving into the top spot.

Edward Allen's heart did not break after all. He remained active for a good number of years following his retirement, continuing to direct the teacher-training Harvard Course until 1949, when it was taken over by Farrell. (Under Waterhouse's administration the course was transferred to Boston University.)

Allen lived to be eighty-nine years old; his wife, the former Katherine Gibbs, whom he had married in 1891 when they were both teachers at Perkins, died in 1952, two years after him. Gabriel Farrell also lived to a ripe age; he was eighty-two when he died in 1968. Ironically, it was Farrell, the erstwhile stranger, who managed to accomplish during his retirement what Allen had long intended but never quite got around to doing. Farrell wrote a book, The Story of Blindness, capsulizing the history of work for the blind up through the middle of the twentieth century.

The depression years saw relative quiescence in curriculum development, although some of the residential schools managed to utilize depression manpower to enrich their supply of teaching materials. With the help of Works Progress Administration workers, the Ohio school constructed a large number of scale models for use in object teaching. In 1941 the Foundation organized a traveling collection of these models, which fitted in well with the Talking Book Education Project. Children who listened to a recorded biography of George Washington, for example, could deepen their understanding through tactual examination of a model of Mount Vernon or one of the Revolutionary War battlefields.

This same era saw the initiation of still another approach to expanding children's learning opportunities. The Dramatic Arts Project was an idea that captured the imagination of M. C. Migel. He had somehow met the actress and dramatic coach Ruth Vivian, a featured player in the Broadway hit The Man Who Came to Dinner, and in the spring of 1939 told the executive committee that he had personally engaged her to demonstrate at three schools for the blind how dramatics could enhance the development of poise and self-confidence.

These trial runs at the Ohio, Maryland and Minnesota schools went so well that the following summer the Major arranged, again at his own expense, to have Miss Vivian and two other coaches conduct a six-week summer course in the techniques of play production. Attended by 16 teachers from as many schools, the course was given at Rest Haven, the vacation home for blind women then still privately financed by the Migel family. Twelve blind students formed the experimental acting company for demonstration purposes.

The course's unmistakable effectiveness in training teachers to conduct dramatics programs in their schools led the Foundation to turn to the Rockefeller Foundation for a two-year grant of $30,000. The application was backed by the results of a questionnaire which established that 37 schools for the blind were keenly interested in adding dramatics to their curriculums but lacked both the financial resources and the expertise to do so. The requested funds would make it possible for three coaches to train faculty members in all of these interested schools, spending five or six weeks in each.

Grant approved, the project got under way in the summer of 1941 with a budget that provided not only the coaches' salaries but the necessary support materials: props, costumes, prompt-books and individual brailled scripts for each part in 24 separate plays. Reduced royalty rates were negotiated with the copyright holders of the selected plays, which ranged from simple one-acters for younger children to more sophisticated full-length comedies such as Sidney Howard's The Late Christopher Bean and Kaufman and Connelly's Dulcy.

The Dramatic Arts venture proved immensely popular with faculty and students alike. During its two-year span more than 200 teachers in 30-odd schools were trained in play production and direction and close to 1,000 blind boys and girls were exposed to their first taste of stage fever. Measures were also taken to correlate dramatics with the basic school curriculum. To enrich classroom work in such subjects as history, English, and social studies, a series of 13 one-act plays, "Dramatic Hours in American History," was produced on Talking Books along with corresponding sets of brailled scripts and prompt-books.

For the first year after Kathryn Maxfield's departure from the Foundation to become director of personnel and research at Perkins, she continued to function as editor of the Teachers Forum, sharing responsibility with Eber L. Palmer, who had just come on staff as Foundation assistant director. Palmer took over as sole editor in September 1933 and remained in charge until he left in 1937 to head the New York State School for the Blind at Batavia, at which time editorship was transferred to his successor as assistant director, P. C. Potts. The Teachers Forum continued as an independent publication until the end of 1941, after which it was merged with the Outlook.

Miss Maxfield remained at Perkins less than two years before moving to a new job where she could pursue what had become her major interest: the psychological study of preschool blind children. In early 1934 she became director of the Arthur Sunshine Home and Kindergarten for Blind Babies in Summit, New Jersey.

Founded in 1909, this was an institution with a complex and not altogether praiseworthy history, that had just undergone a thorough internal reorganization. The new director was employed to give the organization a fresh start. The Home, which had formerly provided primarily custodial care for a mixed population of blind babies and older, mentally retarded blind children, would now adopt a two-pronged service program: as a laboratory where the needs of preschool blind children might be studied, and as a training center for counselors who would visit blind babies in their own homes and extend guidance to their parents.

While still on the Foundation staff Kathryn Maxfield had made a preliminary survey seeking "productive avenues of approach to the problems of the preschool blind child." Case records of 110 such children under the care of nine agencies were analyzed, but the results were foggy and the only conclusion to be drawn was that "the gate to the proper field of knowledge eludes discovery."

Some of the fog was dispelled by what Miss Maxfield accomplished at the Arthur Home before lack of funds forced it to close its residential unit in 1938, and by the studies she conducted during later stages of a long professional career. Her work laid some solid foundations for the major changes that took place in preschool services during the Fifties.

That work with blind children had to begin at an early age had long been recognized. Every teacher had seen children report for school who had not yet learned to use a knife and fork or to tie their shoelaces; some were physically underdeveloped and lacking in basic motor skills; some were excessively timid; some were addicted to such "blindisms" as eye-rubbing, facial contortions, rocking and swaying of the body or other forms of self-stimulation; some were so totally self-absorbed as to be unable to relate to others.

Such developmental lags were less apt to denote intellectual deficiency than inadequate upbringing during the formative years. In the early days of education of blind children, most schools bemoaned this situation but accepted as inevitable that each newly admitted child's first year of education would have to focus as much on overcoming poor parental training as on introducing cognitive learning. Here and there, however, special nursery schools were set up on behalf of blind babies, notably those born to desperately poor families or those maltreated by ignorant or indifferent parents.

The nation's first came into being in Connecticut in the late nineteenth century when Emily Welles Foster, a wealthy and devout churchwoman of the Lady Bountiful era, literally stumbled over a small boy sprawled on the floor of a dimly lit hallway in a Hartford tenement, where she had gone in search of one of her Sunday School pupils. After she had picked him up and assured herself he was not hurt, she learned that he was "blind Tony," aged seven, who spent most of his days lying in the hallway and drumming his feet against the wall.

Seeking out the boy's parents, Mrs. Foster found they were non-English-speaking Italian immigrants whose provincial dialect was so different that they could not understand the phrases she studiously mastered in standard Italian. This dialect was the only language little Tony knew, but somewhat like Anne Sullivan, who at that very time, 1888, was in the early stages of her work with Helen Keller, Mrs. Foster determined to find a way to communicate with him. As she herself was to say, she felt that "language was the key by which the door of his shut-in mind might be opened to our world."

Within a few months she had learned enough of Tony's dialect to begin to teach him the equivalent English words. When, to give him a taste of fresh air and sunshine, she occasionally took the boy to her suburban home for a day or two, she became aware of how much more rapidly he responded to teaching in surroundings where there were fields and trees and birds to provide him with new sensory experiences. Tony's parents could also see the difference, and soon agreed to surrender their son to Mrs. Foster's care. He was joined at her home by another blind child taken from the Hartford almshouse.

Emily Foster's initial objective was to prepare these little boys for schooling; at the time, the state of Connecticut had an arrangement under which it could send 20 pupils a year to Perkins. She accomplished this, but her aims soon broadened to embrace a more general interest in the welfare of all blind people. Among those she encountered while organizing a social club for adult blind residents of Hartford was an attorney, Frank Cleaveland, who in 1893 helped her persuade the Connecticut legislature to enact a bill establishing a Board of Education for the Blind separate from the state's department of charities. It was the first such autonomous agency in the nation, and ironically, its primacy nearly led to its untimely demise. In 1899 the legislature debated a resolution to abolish it "because no other state had one." (A few years later this was no longer a fact; in 1907 Massachusetts established an independent state commission for the blind.)

Under the Connecticut statute, which provided that any visually impaired resident who could not be educated in the common school "is entitled to be educated in such a way and for such a time" as the newly created board decided, the nation's first nursery for neglected blind babies was established in Hartford in 1893 with the help of funds raised by Emily Foster and others she recruited. It was later moved to Farmington, where it remained in operation until the premises were destroyed by fire in 1934. By then social conditions had changed. The ophthalmia neonatorum responsible, in Mrs. Foster's day, for the blindness of so many newborn infants had been largely eradicated, and no one could have anticipated retrolental fibroplasia. Connecticut's nursery was never rebuilt; in its place, the Board of Education for the Blind engaged a "mother's counselor" to serve blind infants through home visits.

The straight-backed, blue-eyed Emily Welles Foster, whose portrait hangs in the offices of the present-day Connecticut education board, served as one of its members by appointment of the governor until her death in 1918. Long before then she had the satisfaction of seeing her first protégé, Antonio Martello, become the self-supporting and respected newsvendor at Hartford's railroad station.

Second in seniority of service for preschool blind children was the Boston Nursery for Blind Babies. It was founded in 1901 by Isabel Greeley who, as a teacher in the Perkins kindergarten, came to realize that the five- and six-year-old children enrolled there would have benefited by much earlier care and training. Her ideas attracted the support of Boston society and the nursery, which started in a private house with three or four small children in residence, soon moved to larger quarters with room for 25. In 1934 a day nursery program was added which, according to an account published at the time, served all preschool children with impaired vision "whether they have no sight or only slightly defective sight" but not "children of low mental capacity." This nursery was still in existence in 1972, although its name had changed to Boston Center for Blind Children and the basic emphasis of its services had been reversed to focus on diagnostic service and residential treatment for emotionally disturbed children who had visual disabilities.

A handful of other residential nurseries subsequently came into being, but by World War II most of these had either closed their doors, changed their programs or been absorbed into general service agencies. For the most part, the nurseries were supported by voluntary contributions; the Los Angeles Nursery School for Visually Handicapped Children, for example, was established in 1938 by Delta Gamma, a sorority group. There was little governmental support for such programs; an item in the Teachers Forum in May 1930 noted that, as of that date, only 13 states were financing services for blind babies.

When the retrolental fibroplasia epidemic struck, many parents turned for guidance to community agencies—child care and family service organizations—whose social work staffs tended to focus less on the day-by-day training of the blind child than on the emotional and psychological impact of blindness on overall family structure and relationships. These social workers knew relatively little about practical training techniques; what they did know, and dealt with, were ways of helping parents come to terms with their feelings about having a blind child.

A 1944 psychological research study analyzing the influence of parental attitudes on the personality development of a blind child divided these attitudes into five fairly distinct but occasionally overlapping categories: acceptance of the child and his handicap, denial of the effects of the handicap, overprotectiveness, disguised rejection, and open rejection. The adjustment mechanisms produced in the children by these differing parental attitudes were also grouped into five classifications: compensatory behavior, denial, defensive behavior, withdrawal, and non-adjustive behavior. While these two sets could not be shown to have a one-to-one correspondence, the general conclusion of the author, Dr. Vita Stein Sommers, was that

blind individuals tended to make a wholesome personal and social adjustment whenever their early life afforded them a reasonable amount of economic, physical and emotional security, whenever they were fully accepted by the members of their family, and the parents were able to face their handicap in an objective way.

None of the later in-depth studies of the blind children—or, for that matter, the general child development studies conducted by authorities such as Erikson—differed materially from this postulation.

In an effort to crystallize and disseminate such insights the Foundation convened a three-day National Conference on the Blind Preschool Child in early 1947. The extent to which interest in this subject had moved out of the restricted circle of agencies for the blind into broader professional areas was evident from the roster of speakers, among them Dr. Lauretta Bender, senior psychiatrist of New York's Bellevue Hospital, Dr. Arnold Gesell, director of Yale Medical School's Clinic of Child Development, and Anna W. M. Wolf of the Child Study Association of America.

Included in the recommendations in the published conference proceedings were two that promptly drew fire from the residential school heads. One was that "the accent should be on leaving the child in his family and providing the family, particularly the mother, with guidance and, if necessary, case work help" from social workers in general casework agencies. Such social workers, though not specifically experienced in the problems of blindness, could nevertheless make use of "sound child-psychological and psychotherapeutic principles." Day nursery services could be a resource for children while their parents were receiving this guidance.

The other was a statement by Robert Irwin that, for the sake of overall unification, responsibility for service to preschool children should be assumed by state commissions for the blind.

At the opening of the next AAIB convention, William E. Allen of the Texas School for the Blind devoted much of his presidential address to an attack on these recommendations. Under optimum conditions, he said, keeping children at home and sending them to day nurseries might be all right in large metropolitan cities, but it was no solution in states like his, where pupils in the school for the blind were drawn from 95 counties scattered over a wide territory. As for state commissions, they dealt primarily with blind adults. Work for the preschool child was

clearly within the field of the residential school for it bears no resemblance to vocational training and placement of the adult blind. Training of the preschool blind child is a forerunner of the primary work done in residential schools. Can you picture a nursery school for the seeing under the control of a United States Employment Bureau?

What Allen was really driving at was the threat that what he termed "social work thinking" would undermine residential school education. Joseph G. Cauffman of Overbrook reinforced that point in his speech. He acknowledged that the social worker had much to contribute "but the program in my estimation should be controlled by educators."

The fears that underlay these protests were real enough. The residential school heads were speaking at a time when a powerful anti-institutional trend dominated child welfare services. All over the country orphanages were being disbanded and their wards placed in foster homes. Child development studies dwelt strongly on the damaging effects of maternal deprivation and the need for the very young child to have a one-to-one relationship with a mothering figure, something not even the best-run congregate institution could supply.

But the fears were also premature. In 1948 the retrolental wave had not yet reached its peak; in a state like Texas, the first case of an RLF-blinded child had yet to appear. During the next two decades sheer numbers would provide enough "business" to tax the facilities of all types of educational programs for blind children. But the suspicion and bitterness touched off by the Foundation-sponsored conference remained and festered for a considerable time. The Foundation, some educators alleged, was out to denigrate and destroy the residential schools.

True, Robert Irwin had never made a secret of his bias in favor of public school education. One of the first challenges faced by Barnett when he succeeded Irwin was to persuade the educators that both his personal attitude and the Foundation's official policy were even-handed. An early staff appointment lent credence to this avowal. As consultant in education Barnett appointed Georgie Lee Abel, whose entire professional experience had been in residential schools: Tennessee and Idaho, where she taught, Iowa where she served for eight years as principal, Overbrook where she held an administrative post. Soon after taking office in August 1950, she addressed an open letter to educators to declare that her office would serve "as a sort of clearing house for outstanding contributions to the education of blind children" from all sources, and that "in all things of an educational nature we hope to develop a sane and sympathetic philosophy which we can share and explain."

A study of programs for preschool blind children, which was Miss Abel's first major undertaking, revealed the paucity and uneven quality of existing services and led to a second national meeting on the subject. Unlike the 1947 conference, which had been opened to a large general audience, the 1951 event was a concentrated four-day work session for 35 selected participants representing education and such collateral disciplines as ophthalmology, psychiatry, psychology and social work. The conference report contained nothing to upset anyone. Its most tangible result was the Foundation's employment, the following year, of a consultant in preschool education, Pauline Moor, whose professional experience in parent guidance included six years on the RLF research team organized by Dr. Theodore Terry.

As the retrolental wave subsided and the incidence of blind infants diminished, the problem of preschool training grew less acute. By the end of the Fifties many of the special services that had sprung up to meet the RLF emergency had been phased out. Within a few short years, however, the nation saw a new crop of blind babies, smaller in total number but in far worse shape. These were the infants born to mothers who, early in pregnancy, contracted rubella (German measles) during the 1963–65 epidemic.

The effects of maternal rubella on the children such mothers bore were seldom limited to a single anomaly. Deafness, cardiac impairment, motor handicaps, and mental deficiency, singly or in combination, were the principal conditions found in these babies; where blindness was added to one or more of these anomalies, the resulting problem was severe.

No exact figure was ever obtained as to the number of multiply handicapped blind children born during this epidemic; one of the more authoritative sources estimated that eye defects were found in 15 to 20 percent of the 30,000 cases. The absence in many states of laws requiring compulsory reporting of blindness (and the lack of enforcement in some states which did have such laws on the books) frustrated efforts to arrive at national counts of either the prevalence or incidence of blindness from any cause. That a blind rubella child also had an additional handicap which was regarded as his major disability meant that many such children were assigned to institutions where agencies for the blind were either unaware of their presence or unable to help them. Although a number of special services were established for multiply impaired blind preschool children, and some schools for the blind organized special educational programs as these children began to reach school age, it could not be claimed, as of 1972, that these efforts represented a comprehensive solution.

Concern with preschool blind children in the Seventies centers on improving delivery of services. The lower incidence and scattered distribution of blindness in babies have eliminated the need for the kind of crash programs that coped with the RLF problem, but these same factors have left parents of blind infants with less ready access to needed help. Recognition of this problem led the Foundation to adopt, as one of its newest priorities, a continuing program of advocacy to help insure delivery of comprehensive services—from parental counseling to special education to vocational guidance and prevocational training—for every blind child. A National Task Force on Early Child Development was organized in early 1972. Under its guidance a number of national and regional seminars were conducted, intensive field surveys were made and two pilot projects were initiated to explore improvement of delivery systems in urban and rural areas respectively. The task force also took note of an increase in the incidence of anophthalmia—the absence of eyes—in newborn infants and at its behest the Foundation began building a national roster of children with this condition. An effort was simultaneously under way to enlist the interest of the National Institutes of Health in undertaking medical research into the cause of anophthalmia, whose etiology is unknown.

"In theory, none of us admits the feeble-minded; in practice, we all have them." When he made this statement to his fellow educators at the AAIB convention in 1916, Olin H. Burritt was spotlighting a long-standing dilemma of schools for blind children. It was this very dilemma that led him to initiate psychological testing at Overbrook, in an effort to identify those children who frustrated the goal of demonstrating that blind children were as capable of academic achievement as the sighted.

That goal was valid enough for the great majority of pupils in schools for the blind. What was also true, however, was that some cases of blindness resulting from hereditary or prenatal causes were accompanied by severe mental retardation, emotional instability or both. And a third truth was that society had made no provision for such children other than placing them in mental hospitals or state schools for the retarded that had no educational services for them.

Borderline cases usually found their way into the residential schools or into the early public school classes for blind children. Robert Irwin reported in 1915 that a study of the sixty blind pupils enrolled in Cleveland's public school classes showed "four feeble-minded children and two suspicious cases who will probably prove within two or three years to be feeble-minded." That same year Cincinnati opened a special public school class for blind children of low mental development. "I do not feel that this is an ideal plan, but I think it is the best that can be provided by a day school," Irwin commented.

What was the ideal plan? Irwin didn't know, and neither did anyone else, either then or fifteen years later, during the 1930 White House Conference on Child Health and Protection, when a spirited colloquy took place between the heads of institutions for retardates and a spokesman for schools for the blind. Two of the former, including Vineland's famous Dr. Goddard, came out flatly in favor of institutional placement. In a statement which rings strangely in modern ears, he said: "The feeble-minded, whether deaf, blind, seeing or hearing, have a right to be happy and they are happy in a well-managed institution. … The Vineland inmates are the happiest group of people I have ever seen."

The superintendents of three other state schools offered a less Pollyannaish view. For the most severely retarded blind children, they said, there was really no alternative to institutional care. However, borderline cases—one superintendent identified these as having an IQ between 40 and 80—"should first be given an opportunity in the school for the blind, and be permitted to remain there as long as the child is making progress." Not only might such a child do better in the company of other blind children, his presence in a group of sighted retardates was a disturbing influence. The solution, said Dr. E. R. Johnstone, who had by then succeeded Goddard at Vineland, was that the schools for the blind should develop special classes for children whose IQs were higher than 30.

Just the opposite, maintained Samuel P. Hayes, speaking for Perkins, Overbrook and schools for the blind in general. The mental institutions should set up special units. "The simple educational activities adapted to low-grade intelligence can be modified so that children with little or no vision can still succeed in them. … " Placing such children in schools for the blind only frustrated them and usually resulted in their being sent home. This sometimes created a moral dilemma. "In many cases these homes are highly undesirable, and the residential schools often keep quite unsuitable children on the chance of improvement rather than … cut off all hope." Schools and classes for the blind had to be relieved of these children, Hayes asserted, because "an undue amount of teacher time has to be given to them" and because their continued presence took up space that "might better be given to promising younger people on the waiting list."

It was clearly a stalemate, and the White House Conference recognized it as such. All the Subcommittee on the Visually Handicapped could do in its final report was recommend that a study be made "to effect some agreement as to placement of responsibility for the training and care of the blind feeble-minded."

Forty years later, the problem had yet to be definitely resolved, but circumstances had brought about both of the proposed solutions. A number of state hospitals and schools for the retarded did in fact set up special units for blind children, and a number of schools for the blind did in fact establish special units for children whose multiple disabilities made for retarded functioning. In addition, there were two private boarding schools and several public school programs exclusively devoted to serving blind children with severe learning problems.

The first such private school was organized in 1921 in a Philadelphia suburb by a forceful, incurably optimistic woman named Jessie Royer Greaves. She had been in her mid-twenties when, having just graduated from what was then called the Emerson College of Oratory in Boston, she visited Overbrook and convinced Edward E. Allen that the pupils would benefit from a course in "physical expression and declamation," which combined public speaking, dramatics, and an exercise regime to overcome awkward body mannerisms. In 1902 Miss Royer (she had not yet married the artist Harry Greaves) became a part-time faculty member; she continued to conduct her special course for 25 years, even after the event that prompted her to start a school of her own.

In 1920 Mrs. Greaves returned to Overbrook following the summer vacation and found that a number of pupils in her class had been sent home because of low IQ scores. She was indignant; from her personal knowledge she felt sure that, despite their poor intellectual ability, these children had potential which could be developed in a non-competitive learning environment. She knew, too, that only two alternatives faced those dismissed: vegetation at home or commitment to a state institution.

Early in 1921 Mrs. Greaves opened the Royer-Greaves school; its hyphenated name was a joint memorial to her late father and the young husband who had died two years earlier. Her fundamental formula, as she later described it, was "music, conversation and much love." With these as opening wedges, she devised ways of training her pupils in self-care and social behavior, of overcoming their speech defects, of building their self-confidence and spurring them to achievement. Steadfast adherence to her goals over a 40-year span won her the Lane Bryant Award in 1961, six years before she died at ninety-two. Another school like hers—the Hope School in Springfield, Illinois—was founded in 1957 by the parents of a mentally retarded blind daughter.

By this time there had surfaced a growing national concern over the large number of deviant blind children who were either too intellectually limited or too emotionally disturbed to be eligible for schools or day classes for the blind. A 1956 survey of New York State's 2,200 blind children had shown one out of ten to have retarded mental development; it had also shown that a large number of the children in this fraction had additional disabilities, with cerebral palsy and epilepsy leading the list.

To grapple with the problem of such multiply handicapped children, national workshops were sponsored by the Foundation in four successive summers beginning in 1959, in conjunction with the special education departments of universities in different parts of the country: Northwestern, Peabody, San Francisco State and Minnesota. The objective was to enlarge the "small but growing corps of persons throughout the United States who have common interest, common concern, and some common bodies of knowledge in regard to this severe problem." The distilled thinking of the four workshops appeared in two compelling publications. No Place to Go, edited by Kathern F. Gruber and Pauline M. Moor and published in 1963, presented a poignant picture of the "lost children within the blind population." No Time to Lose, edited by Miss Moor out of material derived from a seminar the following year, provided a frightening national picture. It asserted that 25 percent of all blind children under the age of 20 were not then (1964) receiving any educational service, but that many among them could in fact be helped through patient, sensitive and skillful handling. One point made in both publications was that routine psychological evaluations of these children and their potential were often misleading due to the absence of accurate measuring instruments applicable to blind children. Case histories were cited to demonstrate that, in spite of dismaying predictions based on routine tests, many children had been helped to a gratifying level of functioning. But there was no surefire formula; methodology was necessarily exploratory and educators had to find the courage to persist with "conviction, love, patience and a creative, daring spirit."

Whether prompted by this daring spirit or by more practical considerations, it proved to be the residential schools that took up the largest share of the challenge posed by the multiply impaired blind child. Among the earliest to make the effort was the Michigan School for the Blind which, in 1962, reported that 35 of its 280 students had severe multiple handicaps and were being taught in separate classrooms and housed in a separate dormitory. This school reported in 1965 its conclusion, drawn from some years of experimentation and study, that "if special treatment and care were provided, a surprisingly large percentage of these children could be habilitated sufficiently so that they might enter either day school classes or residential schools."

The dimensions of the national problem were assessed in 1966 by the Foundation's research staff, which circulated a questionnaire among more than 1,000 schools and classes for blind children, state and local hospitals, voluntary and public agencies concerned with blindness. Admittedly incomplete, the responses produced a sample of some 8,900 multiply impaired blind children; on the basis of the sample, a total national figure of 15,000 such children was estimated. This, wrote Milton D. Graham who compiled the survey report, posed "a national problem that can only be met by a massive national effort to provide services and training." The dollar figures associated with such an effort were also massive—a projection of $50 to $75 million a year for a five-year experimental program involving 4,000 specially trained teachers plus supporting personnel—but, as Graham pointed out, the expenditures might properly be offset against the ultimate total costs of lifelong institutionalization for the approximately 25 percent of these children receiving care at public expense in state institutions.

A possible approach to this monumental task, suggested in a 1968 Foundation policy statement, was to develop regional facilities for diagnostic, treatment, educational, and rehabilitation services so that those in need would find them within a reasonable distance from their homes and no single state would have to assume the full costs. As will be seen in the next chapter, a regional plan was then beginning for one group, the deaf-blind; as of 1972 no comparable arrangement had been established for other categories of multiply impaired blind children.

A more immediate approach, stressed at a 1968 regional institute conducted in the Southwest, was that a larger investment be made in in-service training of both teachers and other personnel in schools for the blind. Charles C. Woodcock, superintendent of the Oregon school, put the existing residential school situation in plain focus. In Oregon, he said, the public school program for the blind was so well developed that "the multiply handicapped child is the challenge that we at the residential school are facing now. These are the children we are going to serve and either we will serve them or we will go out of existence."

Addressing the same conference, in whose sponsorship the Foundation was joined by a group of Texas state agencies and by the Department of Special Education of the University of Texas, J. Max Woolly, superintendent of the Arkansas School for the Blind, supported Woodcock's observations about the demands made on staff: "Only the emotionally strong, well-prepared teacher can survive." The Arkansas school was then serving 36 multiply impaired blind children, using a separate building for this program. Woolly described some of the pupils: a six-year-old girl, not toilet trained, who until she entered the school had spent much of her time sitting on her father's lap; a seven-year-old boy who had never eaten anything except baby foods because his mother had never had the stamina to insist that he learn to chew; another child whose bizarre behavior made him appear "more like a little frightened animal than a little boy"; several children whose excessive hyperactivity could only be controlled by medication. Said the Arkansas superintendent: "The challenge of providing for these children is at times almost beyond human endurance, yet we are convinced after these few years' experience that a great many of these boys and girls can lead independent, happy, contributing lives."

As schools for the blind gradually accepted the task they had so strongly resisted in previous decades, the mental hospitals and state schools for the retarded also began to yield ground. As of the mid-Sixties, some softening of their traditionally negative attitudes toward educational service for blind inmates could be perceived. The Children's Division of the Syracuse Psychiatric Hospital (later known as the Fairmount Institute) established a unit for severely disturbed blind children in 1964 and reported, five years later, that their experience had been comparable to that of the schools for the blind: i.e., with intensive staff effort and the closest kind of interdisciplinary teamwork, these children could be helped to break out of their isolation, relate to other people, control aggressive drives, acquire basic self-care skills, and participate effectively in an educational curriculum.

In a Massachusetts institution for retardates, the Walter E. Fernald State School, a demonstration project on teaching motor development and mobility skills showed that up to 40 percent of the school's 240 blind residents were capable of responding to instruction. In Michigan the Plymouth State Home and Training School set aside a separate building for its 110 blind residents, most of whom were children, and initiated an educational program using differential teaching and motivational techniques according to each patient's age and ability. Close integration with families and community made it possible for some of these children to leave the institution.

Public school educational systems also grew less hesitant about tackling services for the blind child with additional handicaps. In a few cities special day school programs were inaugurated by multiservice agencies for the blind.

The gradual emergence of these efforts did not take place in a social vacuum. Much of the momentum was stimulated by the broader movements on behalf of all handicapped children, movements which drew ever-greater support from public opinion and were increasingly bolstered by federal financing. In this climate, the heads of schools for the blind, although understandably reluctant to abandon their long-cherished emphasis on academic excellence, came to accept the need for a changed role.

From a historical viewpoint, the metamorphosis had philosophic justification. There would never have been schools for the blind in the first place had other educational facilities for visually handicapped children existed. The residential school of the Seventies was continuing to meet the unfilled needs of its day. It was providing academically sound educational opportunities for normally endowed blind children from isolated rural areas where public school facilities could not be efficiently supplied. It was doing the same for children whose families were unable to provide suitable home environments. And increasingly it was supplying special services for children who could not benefit from the usual educational facilities.

There was one other aspect of change that differentiated the contemporary school for the blind from its pioneer antecedents. This was its role in relation to another kind of misfit, the partially sighted child who had too little vision to manage the work in a public school but too much to be taught by tactile methods.

The presence of such children in schools for the blind had always been a matter of concern. Originally they were accepted for the same reason as the totally blind children—there was simply no other place for them to go. But they were a social and educational problem. Before the era of large-print books and optical aids, they were taught touch reading, which often proved to be a self-defeating exercise. In the same 1916 speech that opened up the question of retarded pupils, Olin Burritt also talked about the partially sighted:

We have tried for years to make them use their fingers in lieu of their eyes. In our determination to circumvent nature we have resorted to all sorts of devices from aprons to cover their hands to huge pasteboard collars about their necks which give a classroom equipped with this last device an appearance quite like a monastery.

Burritt argued that such children, if they lived in large cities, should attend their local public schools and be given supplementary assistance by a special teacher employed for that purpose. Arrangements of this kind were already in existence in Boston and Cleveland. "But what about the pupil with partial sight who comes from the sparsely settled rural community? I see no other way than that we must provide him with the necessary eye-instruction in our special schools."

It took a good many years for the eye-instruction formula to be put into effect with any degree of universality. Most schools for the blind stayed with finger-reading for all pupils. Somewhat faster progress was made in the public schools, where either the "Boston system" or the "Cleveland system" was followed. The Boston procedure—a segregated class for semi-sighted children—was initiated by Edward E. Allen in 1913; the Cleveland procedure, originated by Robert Irwin soon thereafter, was a cooperative plan in which partially sighted children took oral work with their regular grades and did their written work in a specially lit and equipped "sight-saving" room under the guidance of a special teacher.

Both systems were predicated on the then prevailing theory that vision had to be "conserved" to prevent further deterioration. It was natural, therefore, that the education of partially sighted children should become a major program element in the work of the National Society for the Prevention of Blindness, which had been organized in 1908. Edward M. Van Cleve, who in 1915 was named managing director of that organization (then known as the National Committee and not yet independently staffed) while serving simultaneously as principal of the New York Institute for the Education of the Blind, emphasized the semantic value of calling these public school classes "sight-saving" rather than "classes for children of defective sight" or "classes for the semi-blind." Their popularity was enhanced, he said, "and the willingness of parents to have their children attend them is secured, by laying emphasis upon the conservation element in their purpose."

As a logical outcome of its advocacy, the NSPB for many years exercised professional leadership in dealing with the education of partially sighted children, operating along lines parallel to the Foundation's work on behalf of children with more severe visual handicaps. This separation of function continued until 1967 when the two national organizations recognized that their respective programs, particularly in the area of teacher training, had moved so close together as to represent duplication of effort. An agreement that year consolidated the two activities under Foundation auspices.

Although a few residential schools started separate sight-saving classes during the Twenties and Thirties, the pace did not really pick up until the middle and late Forties; at the end of that decade 17 or 18 schools for the blind were maintaining specially equipped classrooms in which partially sighted children were taught by visual methods. One reason for the acceleration was that enrollment in residential schools was declining as a consequence of the postwar growth of public schools and classes. Another was a by-product of the 1943 Vocational Rehabilitation Act amendments which, although primarily aimed at services for blind adults, inspired a wave of vision testing and follow-up remedial medical and surgical procedures for visually handicapped children. A joint NSPB-Foundation study in the Maryland and Florida schools for the blind in 1943 found correctable eye defects in a substantial number of pupils who acquired enough sight, after the necessary remedial measures had been taken, to be capable of visual instruction.

The stepped-up movement of the residential schools into education of the partially sighted engendered a certain amount of protest among those who opposed any growth of institutionalization; the professional literature of the Forties featured a number of articles and speeches on both sides of the issue. There was also some backstage maneuvering in opposition to the legislative change which in 1946 authorized the American Printing House to add large-print books to the educational materials it supplied on quota allotment to the schools and public school classes for blind children. The opposition proved futile. A federal survey made in 1960 showed that more than half of the children in the public school classes for the visually handicapped read large print; in the residential schools the print readers came to a substantial 29 percent.

These proportions were more or less unchanged as of 1970, when Printing House statistics showed that of 8,411 children registered in schools for the blind, 4,722 were braille readers, 2,302 read large type, 426 read both, and 961 read neither. The same source revealed that of the 12,812 children enrolled in the public school systems, large-type readers numbered 7,626, or about 60 percent, and braille readers 3,059, or about 24 percent. Also of interest in these statistics was that 12 percent of the combined registration of 21,223 read neither braille nor large type. This last category embraced non-readers, readers of regular ink print and those who were educated primarily by means of recorded materials.

The Sixties saw a state of truce descend on the long-standing issue of residential versus public school education for blind children. Both types of program achieved record heights in enrollment and settled into a fairly steady ratio of 40 percent educated in schools for the blind and 60 percent in public school systems.

Along with the cooling of tempers there gradually developed more amicable teamwork between the professional organization of the educators and other major elements in work for the blind. The American Association of Instructors of the Blind democratized its structure under a revised constitution, adopted in 1952, which had the effect, as its then president, Neal F. Quimby, put it, of changing "from an organizational setup in which the superintendents and a few selected delegates controlled the group, to one in which every member has an equal voice." The change also involved a broadening of the membership base to include persons "affiliated with or interested in" education, guidance, vocational rehabilitation and placement work. AAIB, said Quimby, was no longer "a closed shop." Special efforts began to be made to enlist the interest of the public school educators as well as of such non-teaching personnel as the residential school houseparents. By 1956 AAIB could report a 40 percent membership increase to 1,145; by 1972 this figure had more than doubled to just under 2,500.

Along with expansion came growing pains. One of the measures adopted in tandem with the revised constitution called for AAIB to have its own professional journal. Since discontinuance of the Teachers Forum a decade earlier, the field of education had felt the need for a medium specializing in its own interests. To fill the gap, the International Journal for the Education of the Blind was founded in 1951, initially as an independent non-profit quarterly under a board of trustees headed by Josef G. Cauffman. The early financing and actual printing were supplied largely by the New York Institute for the Education of the Blind under Merle Frampton. In 1954 the Journal was designated as AAIB's official organ and its production moved to the American Printing House for the Blind, with Paul J. Langan, then superintendent of the Kentucky School for the Blind, as editor. As was invariably the case with professional publications of limited circulation, subscription income failed to cover costs and subsidies were needed.

A more serious financial problem was the need for a permanent office and a full-time executive to serve the expanding membership. In 1957 AAIB opened negotiations with the Foundation on "a plan of cooperative endeavor." The educators' earlier suspicions that the Foundation was biased against residential schools had been largely dissipated, partly as a result of forthright speeches made by M. Robert Barnett at the 1952 and 1954 conventions in which he brought the whispering campaigns into the open, and partly because, under Barnett's administration, the Foundation had repeatedly demonstrated its impartial interest and concern in all forms of education. A number of other steps had also brought the two organizations into closer coordination. Under the Foundation's bylaw revisions of 1951 the president of AAIB automatically became a member of the board of trustees (as did the president of AAWB).

The first fruits of AAIB's approach to the Foundation consisted of a $9,000 grant to finance three jointly sponsored institutes in 1958. The following year saw an agreement under which the Foundation undertook to supply $75,000 (in equal installments over a six-year period) as a subsidy toward AAIB's operating budget. On the basis of this assurance AAIB was able to establish office headquarters and employ an executive secretary. The incumbent, as of 1972, was Mary K. Bauman. She had become the executive in 1968, the year the organization changed its name to Association for the Education of the Visually Handicapped (AEVH).

Although profound changes have taken place in the educational provisions for blind children in the 140 years since the first schools opened their doors, the essential goals and many of the problems remain the same.

The United States never favored a closed system for blind people similar to that in some European countries, where many blind persons spent their childhood years in a residential school, their working years in a handicrafts workshop and a home for blind persons on the same premises, and their final years in a retirement home within the same compound. From the beginning, the objective in American work for the blind was integration into open society, with all this entailed in terms of physical, social, and economic mobility.

The education of blind children continues to focus on these aims. Gymnastics and sports constitute important parts of a curriculum designed to give blind children the stamina, agility, and confidence essential to moving about with ease and efficiency. Interscholastic athletic contests, aimed at developing a competitive "never say die" spirit, are encouraged, not only against other teams of blind youngsters but against sighted teams in those events (wrestling, bowling, weightlifting, swimming) where blind contestants can compete on equal terms. Much effort has been devoted in recent years to having blind children gain entree to the regular community programs of such youth organizations as Boy Scouts, Girl Scouts, 4-H Clubs, and others.

Structured orientation and mobility programs now exist in virtually all schools for the blind and in a growing number of public school programs. These are expected to expand as additional trained peripatologists become available.

The question of vocational preparation continues to be a paramount concern. As with all children, the education of blind youth has moved along two basic tracks: the academic, reserved for students preparing for college or a career in business; and the industrial, which originally specialized in the traditional "blind trades" but later opened up to train students in the mechanics of carpentry, metal, and electrical work which would qualify them for assembly line jobs in open industry.

The development of hand skills has come to be seen as an important element in the education of all blind children, as much for avocational purposes as for future employment. When the number of blind children educated in public schools equalled and then began to exceed the number in the residential schools, it became a matter of heightened national concern that, in most public schools, blind students were automatically excused from the manual training courses customarily given in the seventh and eighth grades. The problem, it was recognized, was that the public school industrial arts teachers lacked knowledge of how to bring blind children into a shop program; most did not even know they were capable of mastering the necessary skills.

In 1959, under contract with the then Office of Vocational Rehabilitation, the Foundation convened a national conference on principles and standards of industrial arts education for blind students. Those attending included vocational rehabilitation counselors, placement workers, public school principals, industrial arts teachers and supervisors in public schools, and a similar group working in schools for the blind. They spent three days hammering out a detailed plan, complete with curriculum guides, demonstration lessons, and equipment lists, which could serve as working blueprints for integration of blind students in shop classes. These were tested out in a series of summer sessions for industrial arts instructors. High hopes were entertained, but the benefits proved to be temporary and limited in extent. As of 1972 the degree of participation of blind boys in shop classes in public schools is still in need of substantial expansion. The same holds true of girls in home economics classes, and of both sexes in physical education programs.

Much also remains to be done in the preparation of blind students for productive and satisfying work lives. The acquisition of specific skills is only part of the process; realistic vocational guidance and the inculcation of good work habits and sound mental attitudes are also important elements of prevocational training. In 1972 a National Task Force on Career Education listed 24 separate measures that could be taken to increase the introduction of blind persons into the mainstream of work opportunities, retraining them as need be when former career channels closed and new ones opened. The overall thrust was that education should have as its target "placement and recycling of individuals on a lattice of open career options."