If any ability to perceive sounds is found, every effort should be made to lead the child to use it, and as the most essential use of hearing is in the comprehension of spoken language, the principal effort should be made along that line.

Take three objects, the names of which are short, with the principal vowels quite easily distinguished. A little toy street car, a cap, and a toy sheep, would do nicely to begin with, as the three words, "car," "cap," and "sheep," are not easily confused. Place two of the objects before him, the car and the sheep, and speak the name of one of them, "car," we will say, loudly and distinctly close to his ear, but in such a way that he cannot see your mouth. Then show him the car. Repeat it with "sheep" and show him the sheep. Repeat "car," and take his little hand, put it on the car. Then "sheep," and make him put his hand on the sheep. Continue this process until he will indicate to you the object you name. When he makes only occasional mistakes with two objects, add the cap. When he can get the right one about 90 per cent. of the time, then take three new words, returning occasionally to the first three. Very soon his own name and those of others, with photographs to enable him to indicate which, will prove of interest to him. When he has successfully learned to distinguish a few single words, a beginning can be made on short sentences. Commands that he can execute are convenient. "Shut your eyes," "Open your mouth," "Clap your hands," can follow drill on the three words, "eyes," "mouth," "hands." "Open the window," "Shut the window," "Open the book," "Shut the book," "Open the door," etc. "Stand up," "Sit down." When this beginning has been made, the road is open to the gradual increase in a hearing vocabulary, but do not attempt so much at once as to confuse and discourage the child.

The suggestions already made should be studiously followed throughout his whole childhood. If his hearing is not too seriously impaired, he will begin to attempt to imitate spoken sounds by the time he is twenty-four to thirty months old. But his ability to imitate sounds is not an accurate measure of his ability to hear. He may perceive the sounds much better than he is able to reproduce them. Distinct utterance comes slowly to the child with normal hearing, and still more slowly and imperfectly to the child whose hearing is not good. But the continued effort to make him hear words and sentences is a very valuable exercise for him and should be faithfully continued till he is old enough to respond to the tests of hearing as outlined and it has been definitely proved that he cannot possibly tell whether Ä, or ō or ē is said, no matter how loud or how near the ear the sound is uttered.

The question will naturally arise as to whether the child's hearing of speech can be aided by an electric or mechanical device. When it is possible to make the child perceive the sound of the vowels with the unaided voice uttered very near the ear, I believe it to be better, at first, not to interpose any artificial device. But I have found that sometimes, in cases where the sound perception was not at first sufficient to enable the child to distinguish even the most dissimilar vowel sounds, although uttered loudly close to the ear, I could awaken the attention of the child to sound, and stimulate the dormant power by the use of an Acousticon. After a few months I have been able to dispense with the instrument and use only the unaided voice at close range. Later, when some vocabulary has been acquired through these auricular exercises, it is often desirable to return to the Acousticon and teach the child to use it, in order to extend the distance at which sounds can be heard. By the use of the Acousticon, it then becomes possible to communicate by means of the ear without speaking at such short range. It is not easy, however, to induce a child to use an Acousticon at all times, whereas an adult will take the time and trouble necessary to become accustomed to the instrument, and will put up with the slight inconveniences inseparable from its use.