The University of Michigan, an encyclopedic survey ... Wilfred B. Shaw, editor.
University of Michigan.

THE UNIVERSITY HOSPITAL SCHOOL

By a series of public acts the state of Michigan has invested in and encouraged the development of child health, affording treatment at the University Hospital for those unable to secure care elsewhere. Afflicted wards of the state and crippled children have benefited by these enactments. The work at first was handled by the probate court of the county of residence and later was taken over by the Michigan Crippled Children Commission.

The assembling of children of different ages and illnesses for treatment has necessitated a consideration not only of medical care but of the child as a whole, so that he can make as much progress as possible under hospital conditions. The actual loss of time from school discourages the child and interferes with his recovery. An educational program compatible with his physical strength and with hospital and medical restrictions, and also satisfactory to the local school was a genuine contribution made possible by private generosity.

For years voluntary teaching service had been provided through the generosity of various women's groups in Ann Arbor, students of the University, Page  1098and other individuals. In 1922 the King's Daughters agreed to finance the services of a paid teacher, and Miss Ruby Bernice Carlton (Olivet '08, A.M. Michigan '25) began her teaching duties in September, 1923. Professor Charles S. Berry advised on educational problems, and the King's Daughters continued their financial and personal interest, but administrative responsibility was given to the Social Service Department of the University Hospital.

The establishment of a recognized professional standard of work acceptable to the group to which the child belonged was of great importance. The aim of the school has been to utilize the child's time, energy, and interest, as conditions permit, along profitable educational lines. Repeated surveys and continuous adjustments were necessary to maintain a satisfactory teaching service. Table I records the enrollment.

TABLE IGrowth of Enrollment by School Level
Year Primary Intermed. Junior High Senior High Special Total
1922-23 43 267 14 ... .. 324
1927-28 580 350 317 132 .. 1,379
1932-33 801 560 252 51 37 1,701*
1935-36 755 457 359 114 73 1,758*

In 1923 legislation made classes available for special groups of handicapped and crippled children. Increased interest in the crippled child culminated in the passage of special protective legislation in 1927, which included a provision relating to the education of hospitalized children, itemizing bedside, academic, and vocational instruction, and making a state appropriation thereto. Many adjustments have been necessary because the University Hospital School is effective only in its ability to meet individual needs.

By provision of this act the office of the state superintendent of public instruction was to approve selection of textbooks, teaching methods, curriculum, and selection of teachers. Dean J. B. Edmonson, of the School of Education, was requested to designate some member of his staff to act as representative of the state office in administering these responsibilities. On October 1, 1932, Assistant Professor Louis W. Keeler was appointed Director of Instruction in the Hospital School. Professor Keeler communicated with the schools from which the children had come in order to ascertain the significance of the Hospital School experience. Two methods of appraising the effectiveness of the Hospital School instruction were carried out. It had been the practice of the school to administer the Stanford Achievement Tests to each new patient in order to determine his level of scholastic achievement and to place him properly. These tests had not been given again during the child's stay in the Hospital. As a rule he had been in the Hospital too short a time to make possible an estimation of his progress, but in the case of a child who had been a member of the school for several weeks the tests were repeated at the time of his discharge from the Hospital. As most of the children came from rural homes, it was decided to make a comparison between the results obtained in the Hospital School and similar results obtained by using the same tests in corresponding grades of rural schools. In all grades the Hospital children were older, but accomplishment as shown by the tests was higher.

Another type of appraisal was undertaken in the form of a questionnaire sent to the home teacher when the patient was discharged from the Hospital. By this method it was hoped to ascertain the patient's progress as compared with that of other children in his grade. Most of these reports, except in cases of irregular Page  1099attendance, indicated that returned patients kept abreast of the home school work and in some instances received extra promotions.

Since its establishment the Hospital School has grown steadily. The original program was primarily an academic one. It soon became evident, however, that performance in both mental and physical activities was important and that personality and individual interests should be taken into consideration. The strength and need of the child control his interests. The Hospital, of necessity, has based its program upon public school requirements for the normal child, but has added whatever it could in the way of interest and diversion.

In 1927, with the increased interest of the state in the school, occupational therapy for children was placed on an educational basis. Shop, crafts, and other recreational activities of the regular school curriculum were introduced. Projects begun in the Hospital were continued in school, and school occupations were duplicated in the Hospital. The success of the work in crafts and occupational therapy for older children and young people emphasized the need for continued educational and vocational training.

Remedial work for children has become a part of the school program. Because of overcrowded conditions in both city and small-town schools the average child receives little individual help. In addition, the handicapped child attends school irregularly, and at the end of the year is usually promoted with the group in spite of his inability to do the advanced work. As a result the Hospital School discovered a great need for remedial work in the lower grades. Because of the brief period of time which can be given to each child's academic program, it has been impossible to meet all his needs in this respect. As reading is the main tool for all subjects, remedial instruction has centered about this subject. The Hospital teachers have been able to discover a child's reading handicap shortly after he has begun his work, and a course of training is started as soon as possible. Classification of reading difficulties can be made soon after the child's program has begun. Remedies used to overcome these difficulties vary with the length of the teaching period and the seriousness of the handicap. If a child's trouble is caused by defective vision or hearing, recommendations are made through the social service worker for further examination and medical care.

The following remedies have served to correct long-standing handicaps: consideration and examination of sight and hearing, individual instruction, phonic drill, oral reading, and reproduction of material. Each year more children benefit from this training. Reports from home schools have indicated that continued remedial work recommended by the Hospital School has been carried out in the majority of cases of normally intelligent children and that reading difficulties have been overcome. As the enrollment increased and added appropriations made possible the introduction of new courses, the curriculum was enlarged for both grade- and high-school students.

A full four-year high-school course was offered in 1927-28. During the next two years a complete two-year commercial course was added, and in 1933 and 1934 a three-year course in the sciences for junior and senior high-school students. Special movable equipment which could be used for bedside instruction added much to the interest and standard of the work. In 1934, 1935, and 1936, adult education received special attention, and vocational courses were offered for men and women who wished to prepare themselves for possible self-support. This program has been Page  1100privately financed. The library service has been used to co-ordinate the interests of all groups. Speech correction work for the children of the primary and intermediate grades was offered by the University Speech Department. Lip-reading for the deaf was included in this program. Work was begun with children of preschool age, and a study was made of reading readiness.

Individual teachers have contributed much to the satisfaction, happiness, and profit of the hospitalized child, guiding and encouraging him during his stay in the hospital and helping him to reestablish his sense of security in his own group. Many of these teachers came to the hospital for their first teaching experience, but there were others who had long taught in the public schools. Through careful choice of personnel over a period of years and by encouragement given to individual teachers who wished to further their education and knowledge,

TABLE IIHospital School Personnel
Year Full Time Part Time Volunteers* Student Teachers for Credit
1922-23 1 1 30 1
1927-28 6 3 26 7
1932-33 5 3 5 17
1935-36 6 3 1 4
the standard of performance in the Hospital School has been exceptionally high. The fostering of ambition in teachers during their time of service has led to unusual contributions made by those who afterward went into other fields.