COUNTY BOROUGH OF EAST HAM EDUCATION COMMITTEE ANNUAL REPORT OF THE PRINCIPAL SCHOOL MEDICAL OFFICER FOR THE YEAR 1953 JOHN S. COLEMAN, m.b., b.s. (lond.), m.r.c.s. (eng.) l.r.c.p. (lond.), d.p.h. (eng.) Medical Officer of Health & Principal School Medical Officer. COUNTY BOROUGH OF EAST HAM EDUCATION COMMITTEE ANNUAL REPORT OF THE PRINCIPAL SCHOOL MEDICAL OFFICER FOR THE YEAR 1953 JOHN S. COLEMAN, m.b.. b.s. (lond.). m.r.c.s. (eng.) l.r.c.p. (lond.). d.p.h. (eng.) Medical Officer of Health & Principal School Medical Officer. 2 EDUCATION COMMITTEE (MAY 1953 TO MAY 1954) CHAIRMAN: (2) Mr. Ald„ W.E. Hurford VICE-CHAIRMAN: (2) Mr. Cllr. C.F. Chapman MAYOR: Mr. Aid. L.A.V. Bennett, J.P. DEPUTY MAYOR: Mr„ Cllr. F.W. French Mrs. Aid. W.M. Knight (1) (2) Mr. Aid. C.W, Dixon Mr. Aid. J.A. Hart, J.P. (2) Mr. Aid. E.A. Wood, J.P. (2) Mrs. Cllr. A.B. Cowlan (2) Mrs. Cllr. D.M. Davey (2) Mrs. Cllr. E.M. Devenay (2) Miss Cllr. F.L. Stevens (2) Mrs. Cllr. L. Sutton Mrs. Cllr. D.M. Wood Mr. Cllr. F„G.P. Clayton Mr. Cllr. W. Doran Mr. Cllr. L.L. Griffiths Mr. Cllr. W. Hogarth Mr. Cllr. F.H. Howard Mr. Cllr. A.H.R. Huggett Mr. Cllr. J.A. Kemp Mr. Cllr. A.R. Miller Mr. Cllr. A.G.M. Oakes (2) Mr. Cllr. RcF. Rieketts Mr. Cllr. J.C. Taylor Mr. Cllr. N.R. Thomas CO-OPTED MEMBERS (2) Mrs. M.E. Bennett Rev. V. Hurley Mr, C.E. Ellett Mr. F.J. Phillips Mr. H.J. Pitt (2) Mr. L.S.J. Witter, B.Sc. Dr. L.G. Whitehead (1) Chairman of Care and Welfare Sub-Committee (2) Member of Care and Welfare Sub-Committee 3 TO THE CHAIRMAN AND MEMBERS OF THE EDUCATION COMMITTEE. Mr. Chairman, Ladies and Gentlemen, I have the honour to present my Annual Report on the School Health Service for the year 1953. It has been a year of consolidation in your services, and the expansion of some branches of the department has enabled better work to be done. I refer in particular to the School Dental Service which last year, through lack, of staff, found Itself unable to deal with anything approaching its normal volume of work. I am happy to report that your appointment of an additional dental officer enabled the routine dental inspections of schoolchildren to be increased three-fold. At the same time I would acknowledge the assistance given to the dental service by local dental practitioners who agreed to be employed in our clinics on a sessional basis when sickness among our own staff gave rise to difficulties. The medical staff have been fully occupied during the year and the character of the work has been maintained at a high level. As envisaged in my last report a pre-school medical examination was substituted for the previous "Fitness for school examination". A thorough examination of the child is now given before entry into school, and in consequence the first school examination has been dropped. In my opinion the new pre-school examination has demonstrated its value by enabling physical defects to be round and corrected before the child begins school. In this way those children suffering from minor troubles, for example speech abnormalities, avoid some embarrassment at the onset of their school career. In other cases the Education Department has been able to place children who fall within the handicapped pupil categories in appropriate special classes or schools. The medical staff continue to devote much of their time to the ascertainment of handicapped children, and every care is taken to see that these pupils are given education appropriate to their ability. With the co-operation of the Maternity and Child Welfare Department children with known disabilities are kept under observation from early Infancy to ensure their correct placement later. The advice of hospital consultants is available to assist in this work and is frequently sought. The service continues to have the friendly and efficient co-operation of the hospital consultants both in the specialist clinics and In the hospitals themselves. Reports on children undergoing hospital treatment are made available freely to us by the consultant paediatrician in the local hospital. It should be noted that no child is referred to a specialist without prior consultation with the general practitioner concerned and his full approval. The work of the Child Guidance Clinic expanded during the year, but your appointment of an Assistant Educational Psychologist, a Psychiatric Social Worker, and a Child Therapist, enabled an extra psychiatric team to be formed, and the increased numbers have been adequately dealt with. Your medical staff continue to examine all newly appointed teachers, and routine chest x-ray examination of such teachers has proved to be of great value In protecting the health of the school-children. The volunteer group of school-leaving pupils who began co-operation with the Medical Research Council's team investigating the use of B.C.G. vaccine in the prevention of tuberculosis, are continuing with the trials which will last for three years. The Medical Research Council provide the mobile x-ray unit for the annual chest x-ray, while all follow-up reports are completed by the Council's health visitors. 4 The co-operation of the general practitioner In all matters relating to sickness and Infectious disease In the scholars had been greatly welcomed and valued throughout the year. I am grateful to the Chairman and members of the Education Committee for their continued kindness and support, and would thank the Chairman of the Care and Welfare Sub-Committee for his deep interest and unfailing courtesy and almost passionate devotion to every detail of the work. To iny deputy, Dr. Hay, I owe thanks and gratitude for his most assiduous work In the school health field, and would end by recording my appreciation of the help and loyalty of all members of the school health staff, of the generous assistance of the Chief Education Officer and his staff, and the ready and welcome co-operation of all the Head Teachers in the schools. I have the honour to be, Ladies and Gentlemen, Your obedient Servant, J. S. COLEMAN, Principal School Medical Officer. 5 GENERAL INFORMATION The average number on the school rolls during the year was 16,836 made up as follows Type of school Number of schools Average number on roll County Primary: Infant 17 11,204 Junior 15 County Secondary 11 4,701 Voluntary (Infant and Junior) 4 931 Totals + 44 16,836 + 3 County schools are combined Infant and Junior COMPARATIVE STATISTICS The following table indicates briefly the work of the School Health Service during the year 1953, and shows the comparative statistics for previous years TABLE I 1949 1950 1951 1952 1953 Routine and Special Inspections at School 8,603 7,196 8,016 7,300 8,756 Re-Inspectlons at school 3,142 2,436 2,906 2,510 2,192 Inspections and Re-inspections at clinics 9,686 10,369 8,676 7,831 6,969 Examinations for cleanliness 42,040 37,569 39,868 41,392 36,984 Nurses' Visits to homes 8,012 4,496 4,156 3,123 2,995 ROUTINE INSPECTIONS IN SCHOOLS A. Routine Medical Inspections. The Inspections carried out during the year In the various schools are tabulated below. A detailed analysis of the findings appears in the Appendix. (Tables 5 to 10). 6 Medical Inspection and Re-Inspection at Schools TABLE 2 Infant Junior Secondary I R S I R S I R S (a) County Primary & Secondary Schools Altmore 111 35 - - - - - - - Avenue 141 - - 222 106 4 - - - Brampton 120 - 1 187 78 - 239 7k 1 Burges Manor - - - - - - 290 91 5 Central Park 114 - 1 - - - 252 38 6 Cornwell - - - 321 51 4 214 50 2 Derslngham 141 - - - - - - - - Essex 178 19 1 - - 215 59 - Hartley 150 - - 619 94 6 — - - Kensington - - - 277 150 - - - - Lathom 85 - 2 283 84 - - - - Monega - - - - - - 247 77 - Napier 106 - - 151 102 1 - - - Roman Road 123 31 - 106 40 6 - - - St. Stephens 194 - 4 - - - - - Salisbury 116 - 5 323 76 2 - - - SandrIngham 77 - 1 - - 189 40 - Shaftesbury - - - 471 159 1 - - - Storey Street 76 26 5 128 47 5 - - - Thomas Lethaby - - - - - - 254 82 3 Vicarage 137 — 1 301 125 - - - Wlnsor 154 11 - 180 40 1 - - - Boys' Grammar - - - - - - 281 90 - Girls' Grammar — - - - - - 284 142 5 Technical School of - - - - - - 22 29 - Building (b) Voluntary Schools (R.C.) St. Edward's 55 5 - 74 7 1 - - - St. Michael's 96 16 - 104 39 - - - - St. Wlnefrlde's 49 - - 106 32 - - - - SUvertown 35 13 — 62 18 - — -- - (c) Independent Schools The Maude Wells Schools 11 11 - 5 3 - 6 2 - 2,269 167 21 3,920 1,251 31 2,493 74 22 I. - Periodic Inspections. R. - Re-lnspectlons. S. - Special Inspections B. Routine Dental Inspections Reference to Table 9, page 18 shows that 8,807 'mouths' were Inspected and that of this number 7,634 pupils were found to require dental treatment of one kind or another. Although the totals for Inspection Include 2,727 'specials' which means children who will almost certainly need more urgent treatment, yet the residual 4,907 (7,634 - 2,727) still represents a high proportion of the 7 6,080 children inspected in the periodic age group' In fact 5 out of every 6 pupils required dental treatment and this reflects the parlous state into which the dental services for the priority groupings have fallen since the advent of the National Health Service Act with its concomitant dental staff difficulties mainly due to dispute over salaries. It would appear this part of the financial burden of education properly could be supported in greater measure by the Central Authority, for surely in so vital a matter as the dental care of young children It is no part of the Principal School Medical Officer's duty to produce monies out of a hat like a magician at the circus. His clear duty is to assess the magnitude of the problem and to advise measures to combat it, and so ineluctable a duty should not go by default through lack of funds. C. Audlometric Surveys. Group testing of the hearing of children in their last year at primary school has continued during the year. 1,855 were tested and of these 255 were referred for further investigation. Of 597 who failed the first test, 342 passed on an immediate re-test, Indicating that the failure was due to some cause other than a defect of hearing. Details of cases referred for examination by the specialist are included in the report of the Ear, Nose and Throat Clinic. D. Cleanliness Inspections. There has been a decline In the number of children found to be harbouring nits or head lice, 544 against 608 last year. The Infestation rate of 1.47 per cent is low and reflects the high standard of educative and preventive work carried out by the health visitors, and the steady Improvement In the 'sense of hygiene' being fostered in the borough. The health visitors continue to supervise in person any hygienic measures necessary for the eradication of pediculosis in Individuals and families, assisted by the sanitary staff where, in addition, the disinfestatlon of homes, clothes and bedding was indicated. Number of cleanliness examinations in the schools 36,984 Number of verminous children noted 544 Iafestatlon rate 1.47 per cent SCHOOL HEALTH CLINICS Total attendances during 1953 :- Central (Town Hall Annexe) 4,852 Manor Park (Church Road) 2,579 North Woolwich (Fernhlll St. Baths) 135 Roman Manor (Community Centre) 327 7,893 Total attendances during 1952:- 8,328 8 It will be noted there Is a reduction in the number of attendances at these clinics which may well be due to our increasing co-operation with the family doctor. Whereas in past years, treatment, investigations or referral to hospital were invariably conducted by the clinic doctor and ancillary personnel, there Is now an increasing tendency to refer the case to the family doctor so that his wishes in the matter may be consulted. Many general practitioners desire to treat and investigate their own patients and this is reflected In the fall In attendances at our clinics. Of course should the family doctor not express his specific intention of undertaking the care of the child, the clinic continues with the investigation or treatment. Dental Clinics. Dr. Allan Ross, Principal School Dental Officer, submits the following report on the work, of the School Dental Service in 1953:- "I have the honour to present my report on the work carried out in the dental clinics during 1953. At the beginning of the year under review the staff consisted of two full-time dental officers and one oral hygienist. Most energetic steps were taken to complete the establishment of three, but were unsuccessful until March when part-time help was obtained from a dental surgeon who In July became a member of the full-time staff. The year's working plan was marred by the prolonged sick leave of one of the dental officers. At a particularly critical time the local general dental practitioners came to our aid and three of them worked about six sessions a week. We were extremely fortunate in being able to replace their services by the employment of a full-time dental officer on a temporary basis. In view of the failure In 1952 to fill the establishment, It was decided In January that the two full-time dental officers should commence extra evening sessions. These were successful In every way and proved popular with the patients. During the year a new clinic was erected and the dental accommodation thus made available will make It possible to increase the establishment to four dental officers and one oral hygienist, all with separate surgeries. Even with four dentists we should still have only just over half the number which by modern standards is considered necessary for the priority groups for whom we are responsible. Orthodontics remains an ever increasing problem. Patients have great difficulty In obtaining this form of treatment from private practitioners and may have to wait for three years If they choose to get treatment from a Teaching Hospital. As anticipated in my report of 1952, the dental statistics settled down to something approaching normal during 1953. The routine inspections at school were increased almost three-fold as compared with the previous year. The number of permanent teeth filled showed a slight Increase and the number of deciduous teeth filled decreased. The number of permanent teeth extracted remains very high and will, I fear, remain so until the number of dental officers is considerably increased, thus allowing more conservative treatment to be given. The year ended on a more cheerful note than for many years. The 9 authorised establishment was full and there was every prospect of the services of a fourth dental officer during the following year." It has been felt for a long time that clinic dental services should be available more freely In the north of the borough where (especially In the •Avenues') there Is a relatively dense population including a high number of children of all age groups. It was hoped that with the completion of the clinic extensions at Church Road, It might be possible to employ a fourth dental surgeon to bring to fruition the Education Committee's plan to achieve this desirable end. It Is apparent that the newly constructed dental surgeries with their specialist equipment, cannot be utilized for any other purposes without virtually stripping them out0 Yet the cost of supporting expanding dental services Is a heavy burden on the local authority and one which might rest in greater part on the shoulders of the Minister of Education. However, with the available staff every effort will be made to give the north of the borough as efficient a dental service as possible. Immunisation Clinics. Immunisation clinics for children of all ages are held weekly both at the Town Hall Annexe and at Church Road Clinic, and Immunisation is also carried out during Minor Aliment Clinics at North Woolwich and Roman Manor. The work of the clinics Is shown in the following summary j— Number of clinic sessions 103 Number of children completely immunised 797 Number of children re-Inoculated 215 Percentage of children of school age completely Immunised 69.8 The compelling need for a high Immunity against diphtheria In our school population was never more urgent than at the present time. Many of our classrooms are still overcrowded mainly, It is understood, owing to the shortage of teachers, and In spite of an all round Improvement In Individual and school hygiene It Is felt an outbreak of diphtheria might prove serious in view of the fact that some thirty per cent of our scholars are unimmunlsed. All our energies will be bent during the ensuing year to raise the state of Immunity against diphtheria in our scholars. Physiotherapy Clinics. These clinics continue to play a most Important part In the treatment of numerous medical, surgical and orthopaedic conditions, and undoubtedly prevent the loss of considerable 'schooling time' for a number of scholars, not to mention the saving in 'lost working hours' to many parents who often accompany their children to hospitals for advice or treatment. An Increasing number of children are referred from the Chest Clinic for postural drainage and breathing exercises as well as general ultraviolet light supportive therapy, whilst the general practitioners and hospitals well know that our school-children receive physiotherapy applied by highly trained staff with modern equipment without being placed on a long waiting list. The physiotherapy clinics are Indeed the backbone of several of the other school health clinics In both preventive and therapeutic aspects of the work. 10 Attendances - Town Hall Annexe 2,896 Manor Park l,572 Treatment given - Patients Treatments Sunlight - local and general 155 2,250 Remedial exercises 255 2,527 Electrical and massage 109 794 Child Guidance Clinic Statistics. Number of sessions worked:- Dr. H. Bevan Jones (Psychiatrist) 92 Dr. E„ Huband (Psychiatrist) 92 Miss K. Daunton (Child Therapist) 174 Mrs. P. Cohen (Child Therapist) 28 The Educational Psychologists and Psychiatric Social Workers are full-time members of the staff Number of attendances at Clinic (parents and children):- Psychiatrists and Child Therapist 1,162 Educational Psychologists Psychiatric Social Workers 733 Total 2,367 Analysis of Cases. New cases referred 184 New cases seen by Psychiatrists 121 New cases seen by Educational Psychologists 153 New cases seen by Psychiatric Social Workers 130 Cases waiting to be seen 74 Cases discharged 148 Visits School visits made by Psychologists 234 School visits made by Psychiatric Social Workers - Home visits made by Psychologists 16 Home visits made by Psychiatric Social Workers 18 Mrs. J.F. Stevens, Education-" Psychologist In charge of the Clinic, submits the following observations:- "The work of the Child Guidance Clinic has been greatly facilitated in the last quarter of this year by the appointment of three new staff members. Miss M. Cross, B. A, was appointed as Assistant Educational Psychologist on 1.9.53, and Mrs. A.J. Thompson, B.A. as Psychiatric Social Worker on 28.9.53. With the addition of another Child Therapist, Mrs. P. Cohen, B.A. who commenced duties on 2.11.53, the clinic staff were organised into two psychiatric teams, each consisting of a psychiatrist, psychologist, psychiatric social worker and child therapist. More cases were seen each week and opportunities for treatment, Including intensive therapy, became greater. By the end of the year the waiting list had diminished considerable in comparison with that of the previous year. 11 It will be evident that the total new cases seen included some children referred in 1952 also, and treatment of cases referred in previous years is, of course, maintained. The majority of the children seen were of Junior School age. It is hoped that in future our largest group of referrals will come from the pre-school and Infant school groups, since most problems have their roots in the earliest years of the child's life. The range of symptoms for which children are referred is extremely wide - some of which are listed below;- Acute aggressiveness, temper tantrums, lying, pilfering, excessive timidity, passivity, stammering and speech difficulties, feeding problems, educational difficulties and learning Inhibitions, bed-wetting, soiling, delinquency, truancy, anxiety state, fears and phobias, obsessional and hysterical symptoms and psychosomatic symptoms such as asthma, vomiting, eczema, tics and epilepsy." I have now had ample opportunity to evaluate the work of the Child Guidance Clinic both In relation to education in particular and family life In general. There can be little doubt that teachers and pupils alike have received considerable assistance from the observations, examinations, tests, advices and special statistical analyses which the Educational Psychologists carry out in relation to the work of the schools. As key members of the psychiatric team in the handling of individual and family problems their work has often played the leading role In elucidating problems and effecting a cure. It can truly be said many children have been spared the mantle of delinquency or even criminality which would have fallen on them but for the timely and able intervention of the Child Guidance Clinic. I have been Impressed by the earnest wish of the Educational Psychologists totatch 'em young" before feelings of guilt, fear and anxiety overburden the developing mind and stultify Its potential. At this stage, too, wrong handling by parents and teachers can warp the personality and this tragedy is eminently preventable. A good deal of opinion Is expressed of matters psychiatric by persons who are not in a position to judge the merits or demerits of the work. This class of detractor base their views on what Is popularly described as 'common sense'. Would such persons attempt to advise a diabetic on diet and regimen guided only by similar principles of common sense? The results might well be disastrous. In both cases much study and research are needed to prescribe a satisfactory course of therapy and a new way of life. In both instances therapeutic principles are followed In an endeavour to help the patient, and in both, common sense has prevailed and ended its task with the patient being presented to the therapist for elucidation and action. In conferences and private gatherings I have heard some medical officers and well-informed laymen scoff at the work of the child guidance clinic. I would remind you that Jenner was rediculed for his life-saving theory and practice of vaccination, yet to-day his Is the only world-wide preventive method employed against small pox. I believe large numbers of our children suffer from wrong handling by parents and, to a very much more limited extent, by teachers In schools. 1 firmly believe the child guidance clinics up and down the country are only touching the fringe of preventive work which could obviate much of this warping of the personality and mental illness which overtakes numbers of our young people. I feel their activities should be extended until such time as the 12 parents of a succeeding generation have attained for themselves good mental health in its full implications, and thoroughly assimilated the knowledge of the life of childhood which mak.es for happiness in the child, the family and ultimately in the community. Speech Therapy Clinic. Miss J„R„ Vokins, Speech Therapist, presents the following report on the work of this clinic:- "During the year 1953, 59 new cases were referred to the Speech Therapy Clinic, and the total number of attendances was 1,569. The majority of cases receiving regular treatment have been Dyslallcs, a term covering almost any type of articulation defect. These cases varied In degree from an inability to say 's' to a severe defect in which the child's speech was quite unintelligible and he appeared to be speaking a language of his own. Dyslalla is often accompanied by reading and writing difficulties and, in many cases, advance in these subjects has been accelerated as the child's speech has Improved. Good progress has been made In almost all cases where the parents have been co-operative and the child has been at least of 'low average' mental ability. Other attendances have included a fairly high proportion of stammerers, 2 cases of speech defects accompanying a hare-lip and cleft-palate, and several cases of Rhlnophonia. The latter term refers to voice defects in which there is either insufficient or excessive nasal resonance in the voice, often rendering speech Indistinct. The practice of gradually reducing the number of therapy sessions for the improved cases until their discharge from the clinic, has been continued: this is to prevent any recurrence of the speech defect which can result from an abrupt cessation of treatment. In some cases, treatment in the speech clinic has been temporarily postponed until after treatment in the Ear, Nose and Throat, Child Guidance or Dental Clinics. Approximately one session per week has been devoted to school visiting. The purposes of these visits are;- (1) To check up on a scholar's progress and speech in school. (2) To give the teachers any advice they may ask for in regard to assisting the children with speech defects in school. This may include indicating the way to overcome very slight defects which do not require regular treatment. (3) To check up on children who, for various reasons, have not been attending the clinic. (4) To get further insight into a patient's behaviour and difficulties. (5) To ensure that the school and clinic are working together and not against each other in helping the child. It is regretted that the complete absorption of the number of available working hours by cases requiring regular treatment has prevented any home visiting. There was a change of Speech Therapist during the year when Miss Glover completed her service with the authority at the end of July, During December the speech clinic was transferred from Shrewsbury Road School to the Manor Park Clinic extension where our work is being continued In pleasant and more convenient surroundings." 13 Statistics* Number of cases referred 59 Number of cases treated 158 Attendances for treatment 1,569 Ophthalmic Clinic Mr„ FLA. Morris, Ophthalmic Surgeon, now attends at the Town Hall Annexe seven sessions per fortnight, an additional session every alternate week, having been agreed as from 1.4.53. Statistics are as follows:- Number of clinic sessions 170 Number of children attending 1,849 Number of attendances 4,155 Defective Vision and Squint. New cases 386 Re-examlnatlons 1,319 Glasses prescribed 1,078 Glasses obtained 1,078 Glasses not required 105 Referred to hospital 49 Eye Disease Treated at clinic 133 Referred to hospital 8 The following cases were referred to nospitai ior treatment High Myopia 1 Cataract and Opacities 2 Squint 45 Cyst 2 Other conditions for Investigation 7 Total 57 Ear, Nose and Throat Clinic The following are the statistical details:- Number of clinic sessions 86 Number of children attending 678 Number of attendances 1,369 Defects and Treatment - TABLE 3 Defect Number observed Number treated Referred for operation Tonsils and adenoids 290 33 257 Other throat conditions 5 5 - Defective hearing 92 92 — Otitis Media and discharging ears 43 42 1 Other ear conditions 38 8 30 Nasal deformities 6 6 - Rhinitis 18 18 - Catarrh 59 59 - Other nose conditions 49 49 — Totals 600 312 288 14 Of the cases referred for operative treatment, 257 were for the removal of tonsils and adenoids, one for removal of a polypus in the ear, one for mastoidectomy, two for eustachian catheterisatlon, and 27 for antrum puncture. Included In the above statistics, the following relate to cases referred for investigation following failure in speech audiometer tests in school:- Number of children examined 297 Number of attendances 507 Discharged as not requiring treatment 209 Treated 88 Home Visiting. Home visits made by health visitors and school nurses during the year numbered 2,995. These visits were for the purposes detailed in my report for 1951. Handicapped Pupils. 90 special examinations were carried out during the year and recommendations for special educational treatment were made In respect of 1+6 children as follows:- TABLE 4 Category Number ascertained. Recommendation Ordinary School with special treatment Day Special School Boarding Special School Blind 1 - - 1 Partially Sighted 2 — 2 - Deaf 1 — 1 - Partially Deaf - — — — Delicate 14 — 5 9 † Diabetic — - " - Educationally sub-normal 21 10 11 - Epileptlc - — — - Maladjusted 1 — — 1 ø Physically Handicapped 5 - 2 2 + Suffering from Speech Defect 59 59 — — E.S.N, and Physically Handicapped 1 — 1 — † Diabetic pupils ascertainable until 4.8.53. ø One child ascertained as Physically Handicapped was recommended for home tuition. + Examinations of children with suspected speech defects are not Included In the special examinations under this paragraph, but those requiring speech therapy are classified as Handicapped Pupils. Twelve cases were found to be subject to be dealt with under the provisions of Section 57 of the Act s- Recommended for report to the Mental Health Committee under the provisions of - Section 57 (3) (Ineducable 8 Section 57 (5) (Requiring supervision after leaving school) 4 15 STATISTICAL APPENDIX MEDICAL INSPECTION OF PUPILS ATTENDING MAINTAINED PRIMARY AND SECONDARY SCHOOLS. PERIODIC MEDICAL INSPECTIONS Number of Inspections in the prescribed Groups: Entrants 2,269 Second age group 1,800 Third age group 1,384 Total 5,453 Number of other Periodic Inspections 3,229 Grand Total 8,682 OTHER INSPECTIONS. Number of Special Inspections 4,393 Number of Re-inspections 4,842 Total 9,235 PUPILS FOUND TO REQUIRE TREATMENT Number of individual pupils found at periodic medical inspections to require treatment (excluding dental diseases and infestation with vermin) : TABLE 5 Group For defective vision (excluding squint) For any of the other conditions recorded In Table 6 Total individual pupiIs Entrants 74 339 406 Second age group 192 176 364 Third age group 182 99 266 Total (prescribed groups) 448 614 1,036 Other period inspections 379 399 737 Grand Total 827 1,013 1,773 16 RETURN OF DEFECTS FOUND BY MEDICAL INSPECTION IN THE YEAR ENDED 31st DECEMBER, 1953 TABLE 6 Defect or Disease Periodic Inspections Special Inspections No. of defects No. of defects Requiring treatment Requiring to be kept under observation but not requiring treatment Requiring treatment Requiring to be kept under observation, but not requiring treatment Skin 85 34 312 28 Eyes - a. Vision 827 97 621 55 b. Squint 103 26 105 14 c. Other 30 16 140 22 Ears - a. Hearing 38 22 34 11 b. Otitis Media 4 2 24 3 c. Other 27 8 90 7 Nose or Throat 301 430 379 283 Speech 33 46 37 46 Cervical Glands 5 133 50 74 Heart and Circulation 9 60 15 35 Lungs 19 58 41 23 Developmental - a. Hernia 5 7 6 6 b. Other 15 27 20 22 Orthopaedic - a. Posture 51 56 20 20 b. Flat Foot 55 76 66 27 c. Other 107 216 95 68 Nervous system - a. Epilepsy 4 7 6 7 b. Other 15 23 25 16 Psychological - a. Development 4 11 6 19 b. Stability 8 28 28 26 Other 198 171 895 181 CLASSIFICATION OF THE GENERAL CONDITION OF PUPILS INSPECTED DURING THE YEAR IN THE AGE GROUPS TABLE 7 Age Groups Number of Pupils Inspected A (Good) B (Fair) C (Poor) No. % No. % No. % Entrants 2,269 1,746 76.9 521 23.0 2 0.1 Second age group 1,800 1,415 78.6 378 21.0 7 0.4 Third age group 1,384 1,066 77.0 304 22.0 14 1.0 Other Periodic Inspections 3,229 2,631 81.5 589 18.2 9 0.3 Totals 8,682 6,858 79.0 1,792 20.6 32 0.4 17 TABLE 8 TREATMENT TABLES GROUP 1„ - DISEASES OF THE SKIN (excluding Uncleanliness). Number of Cases treated or under treatment during the year By the Authority Otherwise Ringworm- (1) Scalp 2 — (11) Body 1 — Scabies 1 1 Impetigo 6 — Other skin diseases 548 145 Total 558 146 GROUP 2. - EYE DISEASES, DEFECTIVE VISION AND SQUINT No. of Cases dealt with By the Authority Otherwise External and Other, excluding errors of Refraction and Squint 113 144 Errors of Refraction (Including Squint) 5 1,485 Total 118 1,629 Number of Pupils for whom spectacles were: - (a) Prescribed 1,078 (b) Obtained 1,078 GROUP 3. - DISEASES AND DEFECTS OF EAR, NOSE AND THROAT No. of Cases treated By the Authority Otherwise Received operative treatment: (a) for diseases of the ear - 18 (b) for adenoids and chronic tonsillitis - 546 (c) for other nose and throat conditions - 11 Received other forms of treatment 221 892 Total 221 1,467 GROUP 4. - ORTHOPAEDIC AND POSTURAL DEFECTS (a) Number treated as in-patients in Hospitals 3 By the Authority Otherwise (b) Number treated otherwise, e„g. in clinics or out-patients departments 194 242 18 GROUP 5. - CHILD GUIDANCE TREATMENT Number of Cases Treated Authority's Child Guidance Clinics Elsewhere Number of pupils treated at Child Guidance Clinics 263 3 GROUP 6- SPEECH THERAPY Number of Cases Treated By the Authority Otherwise Number of pupils treated by Speech Therapists 185 - GROUP 7. - OTHER TREATMENT GIVEN Number of Cases Treated By the Authority Otherwise (a) Miscellaneous Minor Ailments 478 47 (b) Other - 1. General debility 839 24 2. Disease of the digestive system 58 10 3. Disease of the nervous system 71 17 4. Disease of the respiratory system 51 20 5. Other Conditions 133 28 Total 1,630 146 TABLE 9. DENTAL INSPECTION AND TREATMENT (1) Number of pupils inspected by the Authority's Dental Offlcers:- (a) Periodic age groups 6,080 (b) Specials 2,727 Total 8,807 (2) Number found to require treatment 7,634 (3) Number referred for treatment 5,256 (4) Number actually treated 3,499 (5) Attendances made by pupils for treatment 10,221 (6) Half-days devoted to:- (a) Inspection 52 (b) Treatment 929 w (7) Fillings: Permenet teeth 1,835 Temporary teeth 664 Total 2,499 (8) Number of teeth filled: Permanent teeth 1,762 Temporary teeth 650 Total 2,412 (9) Extractions: Permanent teeth 1,013 Temporary teeth 4,709 5,722 (10) Administration of general anaesthetics for extraction 2,100 (11) Other Operations: Permanent teeth 1,264 Temporary teeth 645 Total 1,909 19 TABLE 10 INFESTATION WITH VERMIN (I) Total number of examinations in the schools by the school nurses or other authorised persons 36,984 (ii) Total number of Individual pupils found to be Infested 544 (ill) Number of individual pupils in respect of whom cleansing notices were issued (Section 54 (2), Education Act, 1944) 22 (iv) Number of individual pupils in respect of whom cleansing orders were Issued (Section 54 (3), Education Act, 1944)-