EAS 34 COUNTY BOROUGH OF EAST HAM EDUCATION COMMITTEE ANNUAL REPORT OF THE PRINCIPAL SCHOOL MEDICAL OFFICER FOR THE YEAR 1958 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 1958 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. 1. EDUCATION COMMITTEE (MAY 1958 TO MAY 1959) CHAIRMAN: (2) Aid. Mrn. W.M. Knight VICE-CHAIRMAN: (2) Mr. Cllr. C. F. Chapman MAYOR: Mr. Cllr. A.O.M. Oakes, J. P. Mr. Aid. L.A.V. Bennett Mr. Aid. J. A. Hurt, J. P. Mr. Aid. F. H. Howard (2) Mr. Aid. W.E. Hurford Mr. Aid. j. A. Kemp (2) Cllr. Mrs. t).M. Davey Cllr. Mrs. E.M. Devenay (2) Cl]r. Mrs. L Sutton (1) (2) Cllr. Mrs. D.M. Wood Mr. Cllr. R.C. Beadle Mr. Cllr. F.O.P. Clayton Mr. Cllr. W. Doran (2) Mr. Cllr. F.R.W. Easter (2) Mr. Cllr. R. Evans Mr. Cllr. W.J. Foster Mr. Cllr. F.w. French Mr. Cllr. L.L. Orlfflths Mr. Cllr. W.C. Johnson Mr. Cllr. H.F. Lugg (2) Mr. Cllr. R. F. Rlcketts Mr. Cllr. L.W. Rolfe Mr. Cllr. T.H. Wood (2) Mr. Cllr. A. W. Wjrman CO-OPTED MEMBERS: Dr. H.S. Allen (2) Mrs. M. E. Bennett, J. P. Mr. R. A. Horsley Rev. Canon V. Hurley Mrs. M.M. Lawes Mr. H.J. Pitt (2) Mr. L.8.J. Witter, B.8c. (1) Chairman of Caro and Welfare Sub-Committee (2) Member of Care and Welfare Sub-Committee 2. COUNTY BOROUOH OF EAST HAM - EDUCATION COMMITTEE To: The Chairman and Members of the Education Committee. Madam Chairman, Ladles and Gentlemen, I have the honour to present my annual report on the work of the School Health Service for the year 1968. During the course of the year an intensified campaign was launched to encourage good habits of dental hygiene. Films were shown depicting the baneful effects of Indiscriminate sweet eating between meals, the value and techniques of cleaning the teeth dally, and the tooth saving effect of rinsing the mouth with water after meals. The excellent films were followed by a short talk and question time. This soon developed Into a free for all and it Is apparent from the questions that most children up to twelve years of age get little reliable information or Instruction In dental hygiene. The dental report from our Principal School Dental Officer stresses the essential similarity of work In the Local Authority Service and the National Health Service. Any thinking person must acknowledge that a tooth cavity filled In the head of a schoolchlld Is Just as elaborate and time-consuming a technical procedure as when carried out by a dentist In his own surgery. To conjure up fancied differences between the two In order to denigrate the School Dental Officer so as to Justify lesser financial rewards Is to raise up a barrier of entry to this branch of dental work which few new entrants will care to surmount. Needless to say we have little expectation of recruiting more full-time dental surgeons to our depleted service, and In consequence can do only a.minimum of preventive and orthodontic work. As a part of our health education programme In schools, a beginning was made In an anti-smoking campaign. It would appear that the habit of smoking emerges from the domestic pattern In an easy and natural fashion at a very early age. Many boys of ten really enjoy smoking, and girls acquire the taste possibly a little later without much heartsearchlng as to the need, the value, the Immediate cost or the end results of this glamorized banality. We cry out for clean air, and even legislate to achieve it, yet we foul up our living rooms, cinemas, trains and buses with pungent tobacco smoke which sears the eyes and excoriates the tongue and throat of smoker and non-smoker alike. Here, undoubtedly, Is an Instance where charity begins at home for It Is becoming a rare kindness to allow one's neighbours to enjoy the sweet air, and practice at home will earn quicker reward tha!n precept at school. Slowly but surely modern toilets with adjacent facilities for hand washing are being installed In an Increasing number of our schools. This must be considered the greatest single advance In the battle for better personal hygiene In our borough. But must drinking fountains be Installed In the same room where water closets, urinal stands and wash hand basins are fixed? Any thinking person would agree, the potential danger of contamination of the drinking water Jets could be greatly enhanced by this unwholesome contiguity, and In any case should scholars be encouraged to slake their thirst In the sanitary annexe? I am aware that similar drinking fountains are so sited In certain public buildings, nevertheless I would urge the total abolition of this practice In 3. all our schools as militating against the best Interests of hygiene and the health of our school-children. Once again I would refer to the helpful co-operation of the Chief Education Officer and his department and the Head Teachers of all the schools, In maintaining an efficient school health service. Without their help much of the efforts of the Deputy Principal School Medical Officer, Dr. Drummond, would have availed but little to further new ideas for the advancement of hygiene and health education among the scholars. The Health Visitors and School Nurses have made a fine contribution and In every section the administrative staff have been lndefactlgable In their work. Throughout the year the Chairman and Members of the Care and Welfare Sub. Committee have been most generous and understanding in the various problems placed before them, and with such sure support the Principal School Medical Officer can look forward to the years ahead with eagerness and confidence. I have the honour to be, Madam Chairman, Ladles and Gentlemen, Tour most obedient servant, J.S. COLEMAN. PRINCIPAL SCHOOL MEDICAL OFFICER. 4. GENERAL INFORMATION The average number on the school rolls during the year was 16,851 made up as follows:- Type of School Number of Schools Average Number on roll County Primary: Infant 17 8,714 Junior 16 County Secondary 10 6,111 Voluntary (Infant and Junior) 4 954 Day Special (E.S.N.) 1 72 Totals * 45 15,861 * 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 1968. and shows the comparative statistics for previous years:- TABLE 1 1954 1955 1960 1967 1958 Routine and Special Inspection at School 7,589 6,107 7,022 6,137 7,918 Re-lnspectlons at School 3,394 2,689 709 – – Inspections and ReInspectlons at clinics 6,920 5,705 4,702 4,015 3,940 Examinations for cleanliness 42,114 38,901 38,993 29,184 30,540 Nurses' visits to homes 2,695 3,019 2,793 2,788 2,437 ROUTINE INSPECTIONS IN SCHOOLS A. Routine Medical Inspections The value of pre-school comprehensive medical Inspection In the school health clinic Is now firmly established. No longer is it necessary to convince a parent that special provision needs to be made for her child by reason of some handicap - physical or mental - hitherto unsuspected or unrecognised. And no longer Is It needful for teachers to have their already Inflated classes burdened by the presence of a new entrant who falls within the category of'handicapped pupil'. And for such a young pupil correct placement In an environment to match his potential and compensate for his handicap must be a great comfort and least disturbing at a time of great emotional stress. 6. 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 6 to 9). Medical Inspection at Schools TABLE 2 School Infant Junior Secondary I S I S I S (a) County Primary and Secondary Schools Altmore 115 1 : : : : Avenue 75 – 312 – : : Brampton 77 – 160 – 296 – Burges Manor : : : : 312 1 Central Park 49 1 : : 215 – Cornwell : : : : 248 5 Derslngham 61 – : : : : Essex 81 1 131 – : : Hartley 83 – 548 8 : : Kenslngton : : 178 3 : : Lathom 32 – 169 1 : : Monega 67 – 320 1 : : Napier 49 – 320 2 : : Plashet : : : : 333 3 Rectory Manor : : : : 209 4 Roman Road 35 – 82 8 : : St. Stephens 107 – : : : : Salisbury 72 2 207 3 : : Sandrlngham 48 – : : 201 – Shaftesbury : : 356 — : : Storey Street 25 – 47 — : : Thomas Lethaby : : : : 379 1 Vicarage 82 – 329 — : : winsor 94 – 216 — : : Boys' Grammar : : : : 342 2 Girls' Grammar : : : : 273 8 (b) Voluntary Schools (R. C.) St. Edward's 58 – 73 : : St. Michael's 41 – 70 — : : St. Winefride's 31 – 87 — : : Sllvertown 38 – 36 1 : : (c) Day Special School (E.S.N.) Lansbury 3 – 28 – 40 – (d) Independent Schools The Maude Wells Schools 5 – 12 – 5 – 1,328 5 3,681 27 2,853 24 I. - Periodic inspections. S. - Special Inspections 6. B. Audlometric Surveys Group tenting of the hearing of children in their last year at primary School has continued during the year. 942 were tested and of these 67 were referred for further Investigation. Of 159 who fulled the first test, 102 passed on an Immediate re-test. Indicating that the failure was due to some cause other than a defect of hearing. Details of casey referred for examination by the specialist are Included In the report of the Ear, Nose and Throat Clinic. C. Cleanliness Inspections It Is most pleasing to report a further reduction in the number of children found to be verminous. In fact, the total has been reduced almost by half during the year. Routine cleanliness Inspections In the boys' secondary modern schools have been discontinued and attention focussed on the girls In the secondary modern schools among whom the highest rate of Infestation still is to be found. Number of cleanliness examinations In the schools 30,546 Number of verminous children noted 112 Infestation rate 0.71 per cent SCHOOL HEALTH CLINICS Total attendances during 1958:- Central (Town Hall Annexe) 2,162 Manor Parle (Church Road) 1,113 North Woolwich (Fernhlll St. Baths) 82 Roman Manor (Community Centre) 157 3, 514 Total attendances during 1957:- 4,274 The value of the school health clinic remains as an example of a first class service to a 'priority group' within the community. Here, Investigation of physical, mental or emotional aberration In a scholar can proceed under Ideal conditions, with minimal loss of the scholar's schooling time and his parents' working time, without resort to the use of expensive and complicated hospital services. Dental Clinics Dr. Allan Ross, Principal School Dental Officer, submits the following report on the work, of the School Dental Service In 1968:- "The year under review will almost certainly prove to be the one which is recalled with considerable pride In the future. For nearly the whole year there was a full establishment of dentists and more routine and orthodontic treatment and Inspections at school were carried out than ever before. Unhappily, the putlook for the future Is not particularly hopeful. In 1957 the drift of Local Authority dentists back Into private practice began, and following the report of the Royal Commission on Remuneration of Doctors and Dentists In the National Health Service, there Is every prospect of this becoming an avalanche In 1959 and i960. Thus, one of the dental officers resigned at the end of the year, with no prospect of replacement, 7. and there is every possibility of further resignations in 1959. It Is unfortunate that at this critical time the work, of Local Authority dental officers Is so misunderstood. There is a body of opinion which considers that hospital, private and local authority dentists all carry out quite different forms of dentistry. This has arisen from the assumption that dentistry is divisible in the same way as medicine. It is accepted, for example, that Neurological Surgeons, Medical Officers of Health and Oeneral Medical Practtloners all carry out vital but very different branches of medicine. in dentistry there are no such watertight compartments, with the possible exception of a handful of full-time dentists in 'Faclo Maxillary Hospitals', and the senior full-time teaching staff at dental schools, it is safe to say that all dentists spend much of their time doing what has been called "simple" routine treatment. That the most eminent dentists in the profession actually do ordinary fillings and straightforward extractions is obscured by the fact that they often do them outside the National Health Service and therefore this work, does not always appear in any official returns. Thus, it can be said that for practical purposes all dentists spend nearly all their time doing exactly the same work as the dentists carry out in the Dental Clinics of this Borough. With regard to the statistics, it should be pointed out that every child was examined at least once during the year, thus a total of 21,649 routine inspections were carried out on 16,696 pupils. Hie reduction in the number of special inspections in 1966 was maintained, thus emergency cases seen in 1953 have been nearly halved. Perhaps the most encouraging sign is the large increase in fillings in permanent teeth, combined with a reduction in the number of teeth extracted. In addition to the treatment and inspection sessions the Principal School Dental Officer devoted 20 sessions during the year to administration. It was surprising to learn that all other Principal School Dental Officers devoted no less than a minimum of 4/11ths of their time to administration. in this Borough that proportion Is found to be unnecessary as clerical staff is made available by the Principal School Medical Officer to carry out the routine administrative work. The Principal School Dental Officer can then devote his time to clinical work, and those aspects of administration which require his personal attention. Hie amount of orthodontic treatment carried out during the year was greater than the previous year, but fortunately only resulted in a small increase in the number of attendances. Considerable care will have to be taken in the future not to embark upon too many cases. As the salaried dentists leave the service their patients have to be added to those the remaining dentists are already treating. As, following the report of the Royal Commission, there is a possibility of a disintegration of the School Dental Service, It is hoped that machinery on- a national scale will be set up so that current orthodontic cases can, where necessary, be handed over to dentists in the Hospital and Oeneral Dental Services, otherwise numerous cases will have to be abandoned in the middle of complicated treatment, with catastrophic results both dentally and legally. Immunisation The need for a high level of Immunisation among our children has at no time been more Imperative than now. Outbreaks of diphtheria, with fatalities, have been erupting here and there throughout the country and on the continent with hydra-headed malevolence. Doctors, health visitors and leaders of the community must continue to clarion forth the cry. Only 100% Immunity against diphtheria in the first year of life is the safe line of defence. 'Boosters' at 6 years and 10-12 years of age repair the weakened battlements and ensure complete repulsion of later onslaughts of this dread disease. 8 . Immunisation cllnlc.s 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 Ailment Clinics at North Woolwich and Roman Manor. H'e work, of the clinics Is shown In the following summary:- Number of clinic sessions 85. Number of children completely immunised 464. Number of children re-inoculated 635. Percentage of children of school age completely Immunised 94.5 36.8% of all children of school age have had a primary Immunisation or a boosting dose since 1st January, 1954 i.e. within the last 5 years. Orthopaedic Clinic This specialist clinic held by the Senior Consultant Orthopaedic Surgeon In our region, Mr. L. Olllls, M.B.E., F.R.C.S., has proved one of the most valuable In the whole school health service. It will readily be conceded that with physical deformities, whether congenital or acquired, an ounce of prevention is worth many pounds of cure. But the diagnosis and therapeutic advices must stem from the best Informed opinion and we are fortunate to have available to us the services of so able a surgeon as Mr. Olllls. By arrangement, our physiotherapists attend the clinic and are thus enabled In individual cases to obtain verbal Instruction from the orthopaedic surgeon, on the details of physiotherapy, etc. desired for the patient. In other cases, report of progress and response to treatment Is at the same time rendered to the surgeon so that the best possible line of therapy can be pursued. 18 sessions were held and 149 children made 162 attendances. Of the 286 defects listed below by far the majority were defects of the lower limbs and were of a nature to be helped by remedial exercises. Analysis of Defects Feet and Legs 249 Including Pes Planus 70 Hallux Valgus 64 Oenu Valgum 25 Enlarged M. P. Joints 54 Hands and Arms 3 Posture 24 Other Defects 10 Physiotherapy and Sunlight Ultra violet light is given In our clinics mainly for specific skin and glandular dyscraslas, "sub par' nutritional states, and rarely for sub-cllnlcal rickets. On the other hand there has been a vast Increase In the derand for remedial exercises and drills for postural and other muscular and ligamentous defects, as well as remedial and therapeutic breathing exercises for a number of thoracic disorders. In this sphere the hospital clinics are still heavily overworked and our own physiotherapy and sunlight clinics are essential to the care of the priority groups In our community. 9. Attendances - Town Hall Annexe 1,904 Manor Park 1,652 Treatment given - Patients Treatments Sunlight - local and general 89 721 Remedial exercises 472 3,173 Electrical and massage 86 656 Child Guidance Clinic Miss R. Dettmer B.A., Acting Educational Psychologist in charge of the Clinic, submits the following observations:- "The Clinic staff now consists of two full-time Educational Psychologists, two full-time Psychiatric Social Workers, two Consultant Psychiatrists who each attend two sessions weekly, a part-time Child Psycho-therapist who attends six sessions weekly, a full-time Shorthand-typist'and a full-time Clerk-receptlonlst. Mr. F. A. Spooncer, B. Sc., Assistant Educational Psychologist, Joined the staff on 14.7.68. Miss R. Dettmer, B.A. was appointed temporarily as Acting Senior Educational Psychologist on 24.11.58 in the absence of Mrs. J.F. Stevens who is on special leave. Miss D.J. Livingston, B.A., M.S., Psychiatric Social Worker, was appointed a temporary member of staff on 27.10.58. Mr. E. Winter, Child Psycho-therapist who was attending for two sessions weekly resigned on 18.12.58, and he was replaced on 30.12.58 by Miss L.H. Shroeder , Ph.D., who attends' for six sessions weekly. Although there have been a number of staff changes, having a full complement of staff has meant that the waiting list has been effectively reduced, and parents and children are seen for initial interviews almost as soon as they are referred. All members of the clinic team participate in the initial diagnostic assessment of each clinic case. A complete history is taken by the Psychiatric Social Worker, individual intelligence, educational, and personality tests are administered by the Educational Psychologist, and both parents and child are usually seen by the Consultant Psychiatrist. Some children and their parents may then be referred for intensive psychotherapy; the child may be seen several times weekly by the Child Psycho-therapist, with parents coming along for interviews with the Psychiatric Social Worker at the same time. In other cases less frequent visits to the clinic may be recommended. in all cases under treatment clinic staff maintain liaison with school and community health and welfare agencies who are also concerned with the individual family. A small number of children are seen individually at weekly intervals by the educational psychologists for remedial work in the basic school subjects, chiefly reading. A few very severely retarded readers have been discovered among secondary school pupils, and since these are pupils who may soon be leaving school, the problem is urgent. We hope to undertake a survey some time in the future to determine the actual numbers of older children requiring this kind of help. The work of a community Child Guidance Clinic should ideally be mainly preventive in nature. Since the number of actual cases which it can help directly is necessarily small, Its larger function as a mental health agency participating actively in community education and liaison with other community services should be as Important as the clinical services It offers. We hope that the growing acceptance of and interest in child guidance facilities in East Ham will continue, and that we may be able to contribute effectively to the lessening of the anxiety, mystery and Ignorance which still surrounds problems associated with mental health." 10. STATISTICS: No. of new cases referred 118 " " " " seen by Psychiatrists 97 " " " " " " Psychologists 80 " " " " " " Psychiatric Social Workers 86 No. of cases waiting to be seen on 31.12.68 14 No. of cases discharged 130 Total number of attendances (parents and children) 2,181 Specch TherApy Clinic Miss R. Sacks, Speech Therapist, presents the following report on the work of this c-llnlc. "During 1950 a total of 1,225 attendances was made at the Clinic. As usual attendance during the school holidays was apt to be poor and there was a very big drop In attendance during the bus strike In the early part of the year. Ninety new cases were referred for speech therapy and appointments were nade for 00 new children to attend but only 67 of that number actually began treatment here. (Some never attended and others were placed on the supervision list pendlnf further investigations or to allow for spontaneous development.) Twenty-four children were referred for discharge. Four children left the district and one was transferred to a Speech Therapist nearer his school (the RYDER Partially-sighted School, Stepney). Twenty-nine children ceased to attend no reason being given and four children ceased to attend at their parents' request. A number of children referred during the year, or in previous years, continued to receive speech therapy at Lansbury E.S.N. School. The number of children seen there Is not included In the total attendance figure for the year but about ten children were seen each week during the school term. Of the new children admitted, there were 3 with cleft palate speech, one with retardation of speech and language due to partial deafness; 10 stammerers and 43 children with artlculatory defects (ranging from simple "lisps" to grossly distorted speech). A few of these children had retarded language development and some children classed as stammerers, also had artlculatory defects. As In former years, Speech Therapy students from the West End Hospital Speech Therapy Training School, continued to assist, both at Lansbury and at Manor Park. Contacts with schools and with parents were kept up and some school visits were made. In April, a weekly Speech Therapy Session was started at the Town Hall Annexe and another was begun In July at the Child Guidance Clinic, Shrewsbury Road. Arrangements were also completed for a fortnightly session to take place at Storey Street School, North Woolwich. This means that facilities for Speech Therapy will be available over a far greater area of the Borough than In previous years. Ophthalmic Clinic Mr. R.A. Morris, Ophthalmic Surgeon, attends at the Town Hall Annexe on four sessions weekly. We are grateful to him for the consistently high level of service bestowed on our children and for the punctuality and kindness with which the whole of this difficult work Is carried out. 11. Mr. Morris has won for himself the lively admiration of colleagues and staff and the gratitude of hundreds of scholars (and parents and teachers) in sustaining such a fine service to our school-children as well as certain other •favoured" sections of our community. Statistics Number of clinic sessions 198 Number of children attending 1,873 Number of attendances 4,260 Defective Vision and Squint - New cases 365 Re-examlnatlons 1,402 Children for whom glasses prescribed 1,173 Referred to hospital 50 Eye Disease - Treated at clinic 95 Referred to hospital 9 The following cases were referred to hospital for treatment:- Squlnt (for investigation) 18 Squint (for Orthoptic Treatment) 44 Other conditions for investigation 9 Total 71 Four cases of squint were treated in the clinic by occlusion and of 18 sent to hospital for a further opinion, four were recommended for operation. Orthoptic Clinic This clinic is held in East Ham Memorial Hospital, where a session 13 reserved for children referred from our Ophthalmic Clinic. Statistics: Number of Sessions 41 " " New Cases 41 " " Attendances 261 Ear, Nose and Throat Clinic Mr. Savege is to be congratulated on one of the best and most valuable specialist services given to our scholars in East Ham. His punctuality of attendance, kindness and attentlveness to even the smallest needs of the 'most difficult' young subject, and unfailing courtesy to parents and assistants at the clinics, have won for him golden opinions from colleagues in every section of the community alike. A glance at Table 3 will suffice to indicate the volume and variety of the work accomplished and one can only hope that we will be fortunate enough in the years ahead to be able to continue this service at such a high level of efficiency and merit. The following are the statistical details:- Number of clinic sessions 89 Number of children attending 683 Number of attendances 1,310 12. Defecte and Treatment - TABLE 3 CLINICAL REFERRALS SPECH V.CH AUDIOMETER REFERRALS Attendances 1194 110 New Cases. 442 49 No. of Children Attending 616 68 Not Requiring Treatment 53 6 Cases Referred to Hospital for Operative Treatment Antrum Lavage 10 1 Eustachian Catheterlsatlon 3 2 Wax In Ears 1 - Tonsils and Adenoids 260 4 Polypus 2 - Deflected septum 3 - Examination under Anaesthetic 3 2 DEFECTS NOTED TREATED IN CLINIC REFERRED TO HOSPITAL TREATED IN CLINIC REFERRED TO HOSPITAL Diseases of the Ear Otorrhoea 16 - - - Deafness 8 4 14 6 Otitis Media 11 2 - - Otitis Externa 3 - - - Polypus 1 2 - - Other Ear Conditions 19 6 3 2 Adenoids and Chronic Tonsillitis 42 268 1 4 Other Throat Conditions 3 1 " " Nose Conditions Deflected Septum - 3 - - Rhinitis 6 - 1 - Catarrh 35 2 1 - Epistaxis 7 - - - Other Nose Conditions 37 16 1 1 Home Visiting Home visits made by health visitors and school nurses during the year numbered 2,437. These visits were for the purpose detailed In my report for 1951. Handicapped Pupils 94 special examinations were carried out during the year and recommendations for special educational treatment were made In respect of 63 children as follows:- 13. TABLE 4 Category Number ascertained Recommendation Ordinary School with Special treatment DaySpecial School Boarding Speclal School Home Tuition Blind - - - - - Partially sighted 1 - 1 - - Deaf - - - - - Partially deaf - - - - - Educationally sub-normal 19 4 12 3 - Epileptic - - - - - Maladjusted 4 - - 4 - Physically handicapped 7 - 7 - - Suffering from speech defect - - - - - Delicate 32 - 10 20 2 Thirteen children were found to be subject to be dealt with under the provisions qf Section 67 of the Education Act, and were recommended for report to the Mental Health Committee as follows:- Sectlon 67(3) (Ineducable) 0 Section 67(6) (Requiring supervision after leaving school) 7 Lansbury School At the routine medical examinations carried out during the year, among the 71 children seen, 17 defects were found to require treatment and 22 needed observation. In addition, a number of visits were made to the school by several officers to deal with the complex mental, physical and emotional problems of the scholars. This school now takes educationally subnormal pupils In the younger age groups so that the staff have a more extended opportunity to Inculcate good social habits and develop what educational potential presents in the children. We are grateful to Mr. North, the Head Teacher, for his co-operation and records of observations on the pupils which are always at our disposal, and for his advices in individual cases. B. C. G. Vaccination In order that future details of B.C.0. vaccination may refer to the year under review, It has been decided that vaccination will henceforth be carried out during the spring and summer terms. Consequently the appended table relates only to those of the age group born In 1943-4 for which the procedure had not been completed at the end of 1957. 14. TABLE 6. School Consents Refusals 1st tuberculin test NO. vaccinated 2nd tuberculin test Referred for X-Ray +ve -ve Absent +ve -ve Absent Brampton Sec. Girls 74 51 15 54 2 58 66 3 16 Burges Manor Sec. Ourls 100 64 6 18 2 18 27 – 1 5 Plashet Sec. Girls – – – – – – – – – – Rectory Manor Sec. Girl 71 40 7 67 4 56 45 – 3 7 Girls Orammar 67 47 – 20 – 20 21 – 2 – Boys Orammar – – – – – – – – – – Central Park Sec. Boys 79 30 12 64 4 64 58 _ 3 12 Cornwell Sec, Boys 34 13 – – – 12 14 – 2 – Sandringham Sec. Boys 104 43 2 26 5 24 67 – 6 2 Thomas Lethaby Sec. Boys 127 18 6 21 1 21 38 – 8 6 Totals 656 296 47 260 18 273 325 – 27 47 During the year, a case of tuberculosis was discovered at the Burges Manor Secondary School and steps were taken to apply a Heaf test to all pupils whose parents agreed. The test was refused by the parents of 30 children and of those tested 264 were negative and are being offered B.C.G. vaccination during 1959. 194 gave a positive reaction and were referred to the East Hani Chest Clinic for X-ray examination. 68 were absent and will be Included again In 1959. 15. STATISTICAL APPENDIX Number of pupils on registers of maintained and assisted primary and secondary schools (Including nursery and special schools) in January, 1959 15,583 MEDICAL INSPECTION OF PUPILS ATTENDINO MAINTAINED AND ASSISTED PRIMARY AND SECONDARY SCHOOLS (INCLUDING NURSERY AND SPECIAL SCHOOLS) PERIODIC MEDICAL INSPECTIONS TABLE 6. Age Oroups Inspected (By years of birth) No. of pupils Inspected Physical Condition of Pupils Inspected SATISFACTORY UNSATISFACTORY No. % of Col. 2 No. % of Col. 2 (1) (2) (3) (4) (6) (6) 1954 and later – – – – – 1953 21 21 – – – 1952 774 774 – – – 1951 484 484 – – – 1950 234 232 99.14 2 0.80 1949 911 911 – – – 1948 685 685 – – – 1947 1,324 1,323 99.93 1 0.07 1948 654 654 – – – 1945 762 762 – – – 1944 952 952 – – – 1943 and earlier 1,061 1,060 99.91 1 0.09 TOTAL 7, 862 7, 858 99.96 4 0.05 PUPILS FOUND TO REQUIRE TREATMENT AT PERIODIC MEDICAL INSPECTIONS TABLE 7. Age groups Inspected (by year of birth) For defective vision (excluding squint) For any of the other conditions recorded in Part 88 Total individual pupils 1954 and later – – – 1953 – 3 3 1952 54 134 179 1951 30 80 108 1950 37 42 78 1949 115 80 184 1948 100 63 155 1947 181 118 283 1946 105 61 157 1945 136 60 193 1944 173 61 226 1943 and earlier 256 69 307 Total 1,187 771 1,873 16. OTHER INSPECTIONS Number of Special Inspections 3069 Number of re-inspections 933 Total 4002 INFESTATION WITH VERMIN (a) Total number of Individual examinations of pupils In schools by school nurses or other authorised persons 30,546 (b) Total number of Individual pupils found to be Infested 112 (c) Number of Individual pupils In respect of whom cleansing notices were Issued (Section 54(2). Education Act, 1944) 1 (d) Number of Individual pupils In respect of whom cleansing orders were Issued (Section 54(3), Education Act, 1944) – DEFECTS FOUND AT PERIODIC INSPECTIONS TABLE 8 Defect or Disease PERIODIC INSPECTIONS LEAVERS OTHERS TOTAL (T) (0) (T) (O) (T) (O) Skin 10 16 92 38 102 54 Eyes - a. Vision 339 13 848 102 1187 116 b. Squint 2 2 39 9 41 11 c. Other 4 – 24 16 28 16 Ears - a. Hearing 1 1 11 5 12 6 b. Otitis Media 1 1 3 4 4 5 c. Other 5 3 11 5 16 8 Nose and Tliroat 15 10 191 142 206 162 Speech – 1 22 22 22 23 Lymphatic Glands – 1 17 107 17 108 Heart – 10 9 71 9 81 Lungs 2 6 25 108 27 114 Developmental - a. Hernia – – 1 4 1 4 b. Other 2 – 17 30 19 30 Orthopaedic - a. Posture 2 8 30 65 32 63 b. Feet 5 6 71 33 76 39 c. Other 14 41 65 63 79 104 Nervous System - a. Epilepsy – 1 7 – 7 1 b. Other 1 1 13 5 14 6 Psychological - a. Development 4 – 69 4 73 4 b. Stability – – 9 22 9 22 Abdomen 2 4 22 20 24 24 Other 8 9 43 37 51 46 T - requiring treatment 0 - requiring observation 17. DEFECTS POUND AT SPECIAL INSPECTIONS TABLE 9. Defects or Disease SPECIAL INSPECTIONS Pupils requiring Treatment Pupils requiring Observation Skin 322 59 Eyes - a. Vision 116 31 b. Squint 6 3 c. Other 67 33 Ears - a. Hearing 11 8 b. Otitis Media 3 6 c. Other 30 16 Nose.and Throat 171 107 Speech 38 41 Lymphatic Gland 7 20 Heart 6 24 Lungs 19 44 Developmental - a. Hernia 2 2 b. Other 8 2 Orthopaedic - a. Posture 18 11 b. Feet 54 33 c. Other 38 32 Nervous System - a. Epilepsy 1 2 b. Other 15 16 Psychological - a. Development – 2 b. Stability 9 7 Abdomen 11 17 Other 110 66 TREATMENT TABLES TABLE 10. EYE DISEASES, DEFECTIVE VISION- AND SQUINT Number of cases known to have been dealt with External and other, excluding errors of refraction and squint 142 Errors of refraction (Including squint) 1,721 Total 1, 863 Number of pupils for whom spectacles were prescribed. 1,173 18. TABLE 11. DISEASES AND DEFECTS OF EAR, NOSE AND THROAT Number of cases known to have been dealt with Received operative treatment (a) for diseases of the ear 18 (b) for adenoids and chronic tonsillitis 273 (c) for other nose and throat conditions 5 Received other forms of treatment 260 Total 562 Total number of pupils In schools who are known to have been provided with hearing aids (a) in 1958 1 (b) In previous years 4 TABLE 12. ORTHOPAEDIC AND POSTURAL DEFECTS Number of cases known to have been treated (a) Pupils treated at clinics or out-patients departments 296 (b) Pupils treated at school for postural defects – Total 296 TABLE 13. DISEASES OF THE SKIN (excluding uncleanllness) Number of cases known to have been treated Ringworm - (a) Scalp — (b) Body — Scabies — Impetigo 11 Other skin diseases 367 Total 378 19. Of the 378 cases of skin disease shown In Table 13 the following were treated In the school health cllnlcs:- SKIN DISEASES TREATED IN SCHOOL CLINICS, 1958 Impetigo 10. Chilblains 2. Warts 176. Chelropompholyx 3. Abrasions 35. Eczema 1. Insect Bites 1. Local Sepsis 2. Heat Rash 7. Urticaria 1. Athletes Foot 5. Dandruff 6. Bolis 12. Callouses 1. Acne 6. Pityriasis 1. Herpes 9. Dry Skin 11. Spots 26. Blisters 4. Sores 7. Sweat-Rash 1. Burns 4. Papular Rash 1. Plgmentatlon 1. TABLE 14. CHILD GUIDANCE TREATMENT Number of cases known to have been treated Pupils treated at Child Ouldance Clinics 262 TABLE 15. Number of cases known to have been treated Pupils treated by speech therapists 148 TABLE 16. OTHER TREATMENT GIVEN Number of cases known to have been dealt with (a) Pupils with minor aliments 161 (b) Pupils who received convalescent treatment under School Health Service arrangements 39 (c) Pupils who received B.C.G. vaccination 318 (d) Other than above. Debility 93 Nervous Disorders 26 Respiratory Disorders 69 Other conditions 75 771 20. TABLE 17. DENTAL INSPECTION AND TREATMENT (1) Number of pupils Inspected by the Authority's Dental Officers:– (a) At Periodic Inspections 16,696 (b) As specials 1,404 Total 18,100 (2) Number found to require treatment 16,106 (3) Number offered treatment 10,411 (4) Number actually treated 5,147 (5) Number of attendances made by pupils for treatment, Including those recorded at 11(h) 11,034 (6) Half days devoted to: (a) Periodic (School) Inspection 219 (b) Treatment 1,283 Total 1,602 (7) Fillings: (a) Permanent Teeth 4,128 (b) Temporary Teeth 1,443 Total 6,671 (8) Number of Teeth filled: (a) Permanent Teeth 3,742 (b) Temporary Teeth 1, 299 Total 6,041 (9) Extractions: (a) Permanent Teeth 1,385 (b) Temporary Teeth 3, 442 Total 4, 827 (10) Administration of general anaesthetics for extraction 2,076 (11) Orthodontics (a) Cases commenced during the year 110 (b) Cases carried forward from previous year 72 (c) Cases completed during the year 74 (d) Cases discontinued during the year 7 (e) Pupils treated with appliances 147 (f) Removable appliances fitted 172 (g) Fixed appliances fitted – (h) Total attendances 1,191 (12) Number of pupils supplied with artificial teeth 31 (13) Other operations: (a) Permanent teeth 1,271 (b) Temporary teeth 929 Total 2,200