AC 44113 EAS 36 COUNTY BOROUGH OF EAST HAM EDUCATION COMMITTEE ANNUAL REPORT OF THE PRINCIPAL SCHOOL MEDICAL OFFICER FOR THE YEAR 1960 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 1960 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 1960 TO MAY 1961) CHAIRMAN: (2) Ald. Mrs. W.M. Knight VICE-CHAIRMAN: (2) Mr. Cllr. C.F. Chapman MAYOR: (2) Cllr. Mrs. E.M. Devenay, J.P. Mr, Ald. L.A.V. Bennett Mr. Ald. J.A. Hart, J.P. Mr. Ald. F.H. Howard, J.P. Mr. Ald. W.E. Hurford Mr. Ald. J.A. Kemp (2) Cllr. Mrs. R.L. Collett (2) Cllr. Mrs. D.M. Davey Cllr. Mrs. M.M. Lawes (1) (2) Cllr. Mrs. L. Sutton Mr. Cllr. R.C. Beadle Mr. Cllr. F.G.P. Clayton Mr. Cllr. W. Doran Mr. Cllr. W.J. Foster Mr. Cllr. L.L. Griffiths Mr. Cllr. W.C. Johnson Mr. Cllr. H.F. Lugg Mr. Cllr. A.G.M. Oakes (2) Mr. Cllr. R.V.N. Polaine (2) Mr. Cllr. R.F. Ricketts Mr. Cllr. L.W. Rolfe Mr. Cllr. A.C. Smith Mr. Cllr. J.C. Taylor (2) Mr. Cllr. A.W. Wyman CO-OPTED MEMBERS: Dr. H.S. Allen, M.Sc. (2) Mrs. M.E. Bennett, J.P. Mr. A. Dowling (2) Mr. R.A. Horsley Very Rev. Canon V. Hurley Mr. H.J. Pitt (2) Mr. L.S.J. Witter, B.Sc. (1) Chairman of Care and Welfare Sub-Committee (2) Member of Care and Welfare Sub-Committee 2 COUNTY BOROUGH OF EAST HAM EDUCATION COMMITTEE TO: THE CHAIRMAN AND MEMBERS OF THE EDUCATION COMMITTEE Madam Chairman, Ladies and Gentlemen, I have the honour to present my annual report on the work of the School Health Service for the year 1960. A most interesting experiment was begun in May 1960, when the Mayor of East Ham, Councillor Mrs. Sutton, officially opened a new Council building in Katherins Road. The ground floor of this six storey block consists of on the one hand a Child Guidance Centre and on the other a combined Maternity and Child Welfare and School Health Service Clinic. The upper five storeys contain thirty one bedroomed flats. A separate entrance has been provided for each group of users of the building. Despite forecasts of possible difficulties the venture has proved an unqualified success and will surely point the way nationally to a more intensive use of the limited amount of land available for development in our great cities. Also in May 1960 pure tone audiometrlc screening of the hearing of our school children replaced the older and less efficient method of the gramophone audiometer. Although at first screening was confined to the same age group, namely children in their final year (fourth) at Junior school, it was decided that at the commencement of the school year 1960-61 children in their third year would also be screened. In this way by successively combining age groups it should soon be possible to perform routine screening of all children during their second year at Infant school. The pure tone method of screening has many advantages over gramophone audiometry. Not only can children be tested at a much earlier age, but the test is in itself selective so all failures are referred directly, without further investigation, to the specialist clinic at the Town Hall Annexe. For the purposes of this test it has been decided to regard a loss of hearing greater than fifteen decibels at any frequency to warrant referral to the otologist. The importance of auditory screening will be apparent when it is noted that of 2431 children tested during the year, 202 were noted to have some degree of hearing defect and were referred to the Ear Nose and Throat Surgeon. At routine medical Inspection the most frequently recorded defect requiring treatment continued to be visual defect excluding squint which now accounts for two-thirds of all defects noted. There has also been an absolute increase in the incidence of this defect. If the categories of 'requiring treatment' and 'observation' are taken together, the incidence has risen from 67 to 1000 children In 1950 to 119 per 1000 in 1955 and has now reached 180 per 1000. This unfavourable experience is not confined to East Ham but is part of a national trend. It is difficult to believe, In spite of authoritative statements to the contrary, that this deterioration in our children's vision can be due to any factor other than prolonged television viewing. During the year the testing of the near vision of secondary school pupils was introduced as part of the routine medical inspection. It is hoped that in the near future it will be possible to test the vision of each school child annually. Congenital colour vision defect occurs chiefly in males usually affecting the perception of green or less frequently red or both. It is important that any boy who may be considering a career in which normal colour vision is obligatory should be aware of any disability before embarking on a course of training. With this aim colour vision testing using Ishihara plates was Introduced as part of the 12 plus routine medical inspection of secondary school pupils. As failure of the Ishihara test is not absolutely conclusive any boy found to have a colour vision defect who it; considering such a career, should be given a lantern test of the Ministry of Transport type. Of 2619 children tested, 75 boys and 1 girl were found to have some defect of colour vision. 3 As had been anticipated the school dental service remained seriously understaffed with only one full-time and several part-time dental officers. The effects of this staff shortage were to some extent mitigated by the decision in the latter part of the year to purchase a high speed air turbine dental drill for use in the Manor Park. Clinic. The equipment proved to be most satisfactory for not only is the discomfort to the patient greatly decreased, but the time spent in the preparation of a cavity is reduced to a few minutes. As a direct result of the use of this equipment the number of fillings performed at this clinic has increased by 50 per cent. It is hoped to purchase another air turbine drill in the near future for use in the Town Hall Annexe Clinic. It is fitting to end with a word of praise to all the members of the school health service team, doctors, health visitors, nurses and administrative staff, who keep the work, flowing smoothly by painstaking and unstinting effort, and to thank most sincerely Alderman Mrs. Knight, the Chairman of the Education Committee, and Councillor Mrs. Sutton, the Chairman of the Care and Welfare Committee and all the members for their helpfulness and support throughout the year. J. S. COLEMAN M.B., B.S., M.R.C.S., L.R.C.P., D.P.H. Principal School Medical Officer 4 GENERAL INFORMATION The average number on the school rolls during the year was 15,370 made up as follows:- Type of School Number of Schools Average Number on roll County Primary: Infant 16 ) 7,630 Junior 16 ) County Secondary 10 6,765 Voluntary (Infant and junior) 4 898 Day Special (E.S.N.) 1 77 Totals +44 15,370 + 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 1960, and shows the comparative statistics for previous years:- TABLE 1 1956 1957 1958 1959 1960 Routine and Special Inspection at School 7,022 6,137 7,918 8,028 6,164 Inspections and Re-Inspections at Clinics 4, 762 4,615 3,946 4,409 3,806 Examinations for cleanliness 38,993 29,184 30,546 20,553 21,232 Nurses' visits to homes 2,793 2,788 2,437 3,526 2,216 5 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 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 102 3 : : : : Avenue 42 1 – – : : Brampton 83 1 104 – : : Brampton Manor : : : : 257 2 Burges Manor : : : : 384 2 Central Park 72 – : : 242 – Cornwell : : : : 347 6 Dersingham 74 – : : : : Essex 69 4 – – : : Hartley 58 – – – : : Kensington : : 125 – : : Lathom : : 322 5 : : Monega 76 3 238 – : : Napier 59 – – – : : Plashet : : : : 355 6 Rectory Manor : : : : 116 5 Roman Road 1 – 33 1 : : St. Stephens 102 – : : : : Salisbury 59 – 280 – : : Sandringham 26 – : : 246 – Shaf tesbury : : 204 – : : Storey Street 22 – 53 2 : : Thomas Lethaby : : : : 449 – Vicarage 87 2 254 2 : : Winsor – – – – : : Boys Grammar : : : : 271 3 Girls' Grammar : : : : 364 13 (b) Voluntary Schools (R.C.) St. Edward's 62 – 140 2 : : St. Michael's 27 – 31 – : : St. Winefrlde's 48 – 81 – : : Silvertown 9 1 28 – : : (c) Day Special School (E.S.N.) Lansbury 9 – 22 – 40 – (d) Independent Schools The Maude Wells Schools 17 – 8 – 2 – 1104 15 1923 12 3073 37 I. - Periodic Inspections. S. – Special Inspections 6 B. Audiometric Surveys No. Tested Referred to Otologist Jan. - April Group testing using gramophone audiometer 452 44 May - July Pure tone screening of same age group 437 62 Sept. - Dec. Pure tone screening of third and fourth year primary school pupils 1542 96 2431 202 Details of cases referred are included in the report of the Ear Nose and Throat Clinic. C. Cleanliness Inspections No. of examinations in the schools 21,232 No. of verminous children noted 107 Infestation 0.5 per cent. Cleanliness inspections are carried out by the Health Visitor or School Nurse routinely on all children attending primary school. Secondary modern school pupils are not routinely inspected but after consultation with the Head Teacher it may be deemed desirable to carry out a complete hygiene inspection of all the pupils or to examine selected groups or individuals. In addition to examination for infestation by vermin attention is paid to the following; signs of malnutrition or overweight; dental caries or defective oral hygiene; defective vision, spectacles needing repair or replacement or are not worn at all; poor personal hygiene and any matters relating to the well being of the child in the community. SCHOOL HEALTH CLINICS Total attendances during 1960 Central (Town Hall Annexe) 1,808 Manor Park. (Church Road) 1,002 North Woolwich (Fernhill St. Baths) 69 Roman Manor (Community Centre) 131 +Katherine Road 204 3,214 Total attendances during 1959:- 3,614 + From 3.6.60 The opening of the new clinic in Katherine Road has filled a need long felt by the residents of the north west part of the borough. A school clinic should be near to the schools it serves, and in the interests of road safety, children who may come to the clinic unescorted, should not have to cross major roads. The decline in attendances at the school clinics is partly due to advances in therapeutic technique but chiefly to the steady improvement in the health of the school child. A school clinic is held every Monday at Town Hall Annexe Tuesday at Katherine Road Wednesday at Roman Manor day of the working week: Thursday at Town Hall Annexe Friday at Manor Park Saturday at Town Hall Annexe 7 Dental Clinics Dr. J. Lusztig-Martlne, Principal School Dental Officer, submits the following report on the work of the School Dental Service in 1960:- "The general working of the dental clinics shows improvement in most aspects in comparison with 1959. From the statistics it can been seen that practically every child is seen at least once a year; that the number of extractions is static - perhaps decreasing; and that the number of fillings, both permanent and temporary, increased considerably. The waiting list at the Manor Park Clinic is shortening, gradually, and at the Annexe it is reduced to a few days. In urgent cases there is no waiting at all. There is no appreciable increase in the number of orthodontic cases. The staff in 1960 consisted of one full time dental officer and three part time, and much of the improvement is due to the purchase of an air-rotor dental drill for use at the Manor Park Clinic. From my own observation I would say:- (i) That the age group 3-6 years has far better teeth than the national average. (ii) That the greatest number of refusals of treatment occurs in the 7 - 9 year age group. (ill) That the largest number of acceptances and completion of treatment is in the 10-15 year group." Immunisation The need for the maintenance of a high level of immunisation in our population is apparent when it is realised that there have been several outbreaks of diphtheria in the London Area, during the last two years. The majority of cases were amongst those children who had not received the protection of immunisation. It is pleasing to report that there have been no cases of this disease in East Ham and that 94.2 per cent. of children of school age have been immunised. 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:- Number of clinic sessions 48 Number of children completely immunised 595 Number of children re-inoculated 594 Percentage of children of school age completely immunised 94.2 43.8% of all children of school age have had a primary immunisation or a boosting dose since 1st January, 1956 i.e. within the last 5 years. Orthopaedic Clinic It is with regret I report that in October 1960 ill-health forced Mr. Leon Gillis M.B.E., F.R.C.S. to relinquish charge of the orthopaedic clinic which was started under his guidance in 1954. Mr. Whitchurch Howell F.R.C.S. has now taken over the conduct of this clinic. The early treatment of minor orthopaedic defects of childhood is of paramount importance in the prevention of chronic crippling disease of joint and bone in later life. 24 sessions were held and 156 children made 195 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. 8 Analysis of Defects Feet and Legs 146 including Pes Planus 44 Hallux Valgus 16 Genu Valgum 26 Enlarged M.P. Joints 4 Hands and Arms 3 Posture 12 Other Defects 17 Physiotherapy Clinic As it proved impossible to recruit replacements because of the present acute national shortage of physiotherapists, the retirement of Miss Broome and Miss Boss in September 1960 seemed likely to deal a mortal blow to this essential service. Fortunately for the priority groups of East Ham these loyal members of the staff volunteered to continue working on a part-time basis of four sessions each per week until the vacancies were filled. It is deplorable that the pay and conditions of service in this skilled and devoted profession have been allowed to decline to such a level that an adequate supply of recruits is not forthcoming. Attendances - Town Hall Annexe 1,033 Manor Park 770 Treatment given - Patients Treatments Sunlight - local and general 19 140 Remedial exercises 286 1,306 Electrical and massage 72 417 Child Guidance Centre Mr. F.A. Spooncer, Educational Psychologist in charge of the Centre, submits the following observations "The staffing of the Centre improved during the year from its parlous position at the end of 1959. Miss Eva Gordon, B.A., who became Mrs. Hopwood later in the year, joined the Centre staff on the 18th January 1960 as a Social Worker and Miss L.M. Spencer, B.A., was appointed as Assistant Educational Psychologist from 29th August. Miss Schroeder was granted a further increase in her therapy sessions to ten sessions weekly commencing on the 1st November 1960. The results of these appointments can be seen in the increased number of referrals to the Clinic and particularly in the considerable number of children who can be helped by regular therapy. The year was further marked by the transfer of the Centre to its new home in Katherine Road where the venture of combining several Clinics in association with a housing project forms an interesting development in this field. The premises most certainly make a much happier impression on children and parents who seek help and it is perhaps significant in this connection that the number of direct parent referrals is increasing. There have been no major difficulties in settling into the new premises and the Clinic has been able to run smoothly since its formal opening on May 21, by the Mayor, Councillor Mrs. Sutton. The statistics for this year show an increase in the number of referrals, partly related to the better staffing position but also undoubtedly resulting from a more wide-spread knowledge of the Centre. Whilst the pattern of ages of referral remains quite similar with the bulk of referrals coming from the Junior School group, the sources of referral do show some changes COUNTY BOROUGH OF EAST HAM EDUCATION COMMITTEE With the Compliments of the Principal School Medical Officer School Health Service, Town Hall Annexe, East Ham, E.6. 9 Ages of Referral Boys Girls Pre-School 11 104 58 Infant School 27 Junior School 62 Secondary " 47 Special School 4 Grammar School 8 Others 3 The number of referrals by parents shows a continued increase and there is also a very substantial increase in the number of children referred by General Practitioners with whom there is gradually growing up a much closer contact. Classification of the problems of children referred is, of course, very difficult. However, an attempt has been made at the analysis of problems of children who remained under treatment at the end of the year with the following results:- pattern of referral problems: Aggressive behaviour 22% Withdrawn behaviour 15% "Behaviour disturbance" (not specified) 25% Stealing 16% Lying 4% Difficulties connected with School 30% Learning difficulties 12% Truancy or school refusal 5% Speech difficulties 5% Sleeping difficulties 10% Psychosomatic disorders 5% Tics 7% Encopresis or enuresis 15% The above data are taken from the problems as referred and many children present several problems at the same time. There are, of course, a very great number of other children who are seen by the Educational psychologists for difficulties in learning; the numbers quoted above as "learning difficulties" refer to those cases where the difficulty appears to be directly associated with an emotional problem. A more systematic enquiry will be conducted during 1961 as part of a large scale analysis of patterns of referral problems being conducted by the University of Birmingham." Speech Therapy Clinic "Miss R. Sacks, Speech Therapist, presents the following report on the work of this clinic. A total of 1,101 attendances was made at the clinic during 1960. This figure does not include the children seen at Lansbury E.S.N. School, an average of 12 children a week being seen there during term time. Sixty-eight new cases were referred for speech therapy and appointments were made for fifty-eight new children to attend (but only thirty-eight out of that number actually began treatment here). Sources of Referral School Medical Officer 56 Schools & Educational psychologist 38 Parents 17 Practitioners 10 Juvenile Court 26 Others 15 10 Nineteen children were referred for discharge and one child left the district. Ten children ceased to attend (no reason being given) and another ten children failed to keep first appointments. Of the new children admitted, the majority had defects of articulation Some had grossly distorted speech, sometimes associated with a generalised language difficulty, and others had an articulatory defect which involved only one or two consonants. One child had cleft palate speech, one was partially deaf and one had a speech defect resulting from a brain injury. There were six stammerers. Weekly sessions at Lansbury School, the Town Hall Annexe and the Child Guidance Clinic were continued, and the fortnightly session at Storey Street School was changed to a weekly session. Students from the West End Hospital Speech Therapy Training School assisted during term time, both at Lansbury School and at Manor Park Clinic. Attendances continued to drop sharply during the school holidays and, as usual, attendance in bad weather was poor, but most of the children who attended regularly made satisfactory progress during the year." Ophthalmic Clinic Mr. Morris, ophthalmic surgeon, holds four clinic sessions weekly at the Town Hall Annexe. As visual defect is now the most frequently noted defect at routine medical inspection it was decided after consultation that the following earliest deviations from the norm warranted not a period of observation in the school clinic but direct reference to the Ophthalmologist:- 1. Distant vision of 6/9 or worse in either eye. 2. Near vision of N8 or worse. Although this may well mean an increased case load falling on an already very busy clinic, it should ensure that corrective measures are instituted at the earliest possible opportunity. I should like to thank Mr. Morris for the keen interest and willing co-operation he has shown in these developments. Statistics Number of clinic sessions 203 Number of children attending 1,946 Number of attendances 4,330 Defective Vision and Squint - New cases 382 Re-examinations 2,073 Children for whom glasses prescribed 1,140 Referred to hospital 26 Eye Disease - Treated at clinic 102 Referred to hospital 9 The following cases were referred to hospital for treatment: Squint (for Investigation) 15 Squint (for Orthoptic Treatment) 21 Other conditions for investigation 9 Total 35 Nine cases of squint were treated in the clinic by occlusion and of fifteen sent to hospital for a further opinion, three were recommended for operation. 11 Orthoptic Clinic This clinic is held at East Ham Memorial Hospital, where a session is reserved for children referred from our Ophthalmic Clinic. Statistics: Number of Sessions 42. " " New Cases 33 " " Attendances 219 Ear. Nose and Throat Clinic Mr. Savege F.R.C.S. and Mr. Cammock B.M., B.Ch., each hold a clinic weekly at the Town Hall Annexe. Whilst there has been a slight decline in the number of clinical referrals from general practitioners and our own medical staff, there has been a five-fold increase in referals from audlometric screening, particularly as a result of the programme of routine pure tore testing in schools. It is of interest to note that the number of cases of deafness noted on clinical referral has remained constant but the number discovered by routine audiometry has trebled. Mr. Cammock in particular has been associated with the pure tone screening programme, and I would like to express my appreciation for the help and assistance he has so freely given. The following are the statistical details Number of clinic sessions 96 Number of children attending 780 Number of attendances 1,560 Defects and Treatment - TABLE 3 CLINICAL REFERRALS AUDIOMETER REFERRALS Attendances 1,157 403 New Cases 301 230 No. of Children Attending 535 245 Not Requiring Treatment 60 109 Cases Referred to Hospital for Operative Treatment Mastoidectomy 3 2 Tonsils and Adenoids 185 12 Polypus 2 – Antrum Lavage 1 – Laryngoscopy 1 – Myringoplasty – 1 DEFECTS NOTED TREATED IN CLINIC REFERRED TO HOSPITAL TREATED IN CLINIC REFERRED TO HOSPITAL Diseases of the Ear Otorrhoea 7 2 1 – Deaf ness 21 2 22 6 Otitis Media 8 1 – – Otitis Externa 5 1 4 – Polypus 2 2 – – Other Ear Conditions 35 – 27 2 Adenoids and Chronic Tonsillitis 10 185 – 12 Other Throat Conditions 1 2 – – Nose Conditions Rhinitis 15 1 1 – Catarrh 24 – 4 – Epistaxis 5 – 5 – Other Nose conditions 18 2 4 – 12 Home Visits Home visits by health visitors and school nurses during the year numbered 2,216. Handicapped Pupils 54 special examinations were carried out during the year and recommendations for special educational treatment were made in respect of 41 children as follows:- TABLE 4 Category Number ascertained Recommendation Ordinary School with Special treatment Day Special School Boarding Special School Home Tuition Blind – – – – – Partially sighted 2 – 2 – – Deaf – – – – – Partially deaf 1 – 1 – – Educationally sub-normal 20 6 11 3 – Epileptic – – – – – Maladjusted 3 – – 3 – Physically handicapped .. 5 – 5 – – Suffering from speech defect – – – – – Delicate 10 – 4 6 – Eleven children were found subject to be dealt with under the provisions of section 57 the Education Act (from November 1st as amended by the Mental Health Act of 1959) and were recommended for report to the Mental Health Committee as follows: Incapable of receiving education or unsuitable for education 6 Requiring supervision after leaving school 5 Lansbury School At the routine medical inspections carried out during the year, amongst the 71 childen seen the very high figure of 25 defects requiring treatment, and 12 defects needing observation, were noted. In addition as these children require a greater degree of medical surveillance than those attending normal school, frequent visits were paid to the school to discuss individual problems with the staff. I would like to thank Mr. North for his co-operation and assistance in dealing with the many mental, physical, emotional and social problems affecting the pupils at Lansbury School. B.C.G. Vaccination and the Prevention of Tuberculosis During 1960 a pupil attending one of the secondary schools was admitted to hospital suffering from pulmonary tuberculosis. Contacts in her school and those childen who had been in the same class in her previous school were Heaf tested. All members of the staff of the schools concerned were x-rayed at the Chest Clinic. All investigations proved negative and no evidence of any other tuberculous infection was found. The B.C.G. vaccination of school children of thirteen years of age is performed in all secondary schools. The number is inflated by the inclusion of older pupils whose vaccination had been postponed because of the intensive poliomyelitis vaccination campaign of the previous year. In the two years 1959 and 1960 of the 1,508 children Heaf tested 208 gave a positive reaction, a percentage of 13.7. In 1956 20% of children tested showed a positive response. This shows that the number or children who have had a tuberculous infection is rapidly decreasing but the need for active immunity as provided by B.C.G. is increasing. I 13 TABLE 5 School Consents Refusals Heaf Tests Positive Ref. Chest Clinic Negative Not Read Vaccinated Brampton Manor Sec. Girls 76 70 27 53 13 53 Burges Manor Sec. Girls 146 80 16 80 6 76 Plashet Sec. Girls 90 63 10 93 21 93 Rectory Manor Sec. Girls 76 36 9 69 8 68 Girls Grammar 85 45 8 137 4 130 Boys Grammar 84 49 12 100 5 99 Central Park Sec. Boys 88 40 20 73 17 72 Cornwell Sec. Boys 63 27 7 72 4 72 Sandringham Sec. Boys 94 37 13 94 2 91 Thomas Lethaby Sec. Boys 157 40 15 133 7 133 Lansbury Special 5 - 3 6 2 3 Totals 964 487 140 910 89 892 NOTE The figures for consents and refusals relate only to pupils in the 13 year age group. The apparent discrepancies between these and the remaining figures are due to the fact that the latter include children whose vaccination was not completed in previous years. 14 STATISTICAL APPENDIX Number of pupils on registers of maintained and assisted primary and secondary schools (including nursery and special schools) in January, 1961 14,767 MEDICAL INSPECTION OF PUPILS ATTENDING MAINTAINED AND ASSISTED PRIMARY AND SECONDARY SCHOOLS (INCLUDING NURSERY AND SPECIAL SCHOOLS) PERIODIC MEDICAL INSPECTIONS TABLE 6 Age Groups 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) (5) (6) 1956 and later 5 4 80.0 1 20.0 1955 9 9 100 – – 1954 698 695 99.6 3 0.4 1953 372 372 100 – – 1952 204 204 100 – – 1951 533 532 99.8 1 0.2 1950 432 430 99.5 2 0.5 1949 558 556 99.6 2 0.4 1948 351 351 1C0 – – 1947 839 839 100 – – 1946 949 949 100 – – 1945 and earlier 1,150 1149 99.9 1 0.1 TOTAL 6,100 6090 99.8 10 0.2 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 Table 8 Total individual pupils 1956 and later – 1 1 1955 1 1 2 1954 53 94 134 1953 31 54 75 1952 28 27 46 1951 72 61 124 1950 79 57 124 1949 85 56 135 1948 71 43 112 1947 146 77 209 1946 150 70 205 1945 and earlier 257 77 310 Total 973 618 1,477 15 OTHER INSPECTIONS Number of Special Inspections 2,914 Number of re-inspections 956 Total 3,870 INFESTATION WITH VERMIN (a) Total number of individual examinations of pupils in schools by school nurses or other authorised persons 21,232 (b) Total number of Individual pupils found to be infested 107 (c) Number of individual pupils in respect of whom cleansing notices were issued (Section 54 (2), Education Act, 1944) 4 (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) (O) (T) (O) (T) (O) Ski n 20 36 70 66 90 102 Eyes - a. Vision 336 24 637 105 973 129 b. Squint 6 1 45 7 51 8 c. Other 8 4 29 21 37 25 Ears - a. Hearing 4 4 12 8 16 12 b. Otitis Media 5 3 13 20 18 23 c. Other 4 – 2 2 6 2 Nose and Throat 14 20 72 165 86 185 Speech 1 1 28 22 29 23 Lymphatic Glands 1 8 4 100 5 108 Heart 3 15 7 47 10 62 Lungs 3 11 9 63 12 74 Developmental - a. Hernia – 1 2 4 2 5 b. Other 5 14 25 35 30 49 Orthopaedic - a. Posture 9 21 18 63 27 84 b. Feet. 2 16 24 39 26 55 c. Other 19 49 54 77 73 126 Nervous System - a. Epilepsy 2 1 4 5 6 6 b. Other – 2 6 12 6 14 Psychological - a. Development 6 1 66 2 72 3 b. Stability 1 1 18 14 19 15 Abdomen 1 3 13 27 14 30 Other 4 6 52 11 56 17 T - requiring treatment 0 - requiring observation 16 DEFECTS FOUND AT SPECIAL INSPECTIONS TABLE 9 Defect or Disease SPECIAL INSPECTIONS Pupils requiring Treatment Pupils requiring Observation Skin 356 36 Eyes - a. Vision 155 67 b. Squint 23 15 c. Other 71 6 Ears - a. Hearing 13 5 b. Otitis Media 13 10 c. Other 21 5 Nose and Throat 155 11 Speech 32 34 Lymphatic Glands 20 50 Heart 6 27 Lungs 30 37 Developmental - a. Hernia – 9 b. Other 8 12 Orthopaedic - a. Posture 5 10 b. Feet 46 45 c. Other 47 39 Nervous System - a. Epilepsy 1 – b. Other 10 8 Psychological - a. Development 10 – b. Stability 17 9 Abdomen 16 10 Other 178 16 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 154 Errors of refraction (including squint) 1,870 Total 2,024 Number of pupils for whom spectacles were prescribed 1,140 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 9 (b) for adenoids and chronic tonsillitis 197 (c) for other nose and throat conditions 1 Received other forms of treatment 283 Total 490 Total number of pupils in schools who are known to have been provided with hearing aids (a) in 1960 2 (b) in previous years 7 TABLE 12 ORTHOPAEDIC AND POSTURAL DEFECTS Number of cases known to have been treated (a) Pupils treated at clinics or out-patients departments 195 (b) Pupils treated at school for postural defects – Total 195 TABLE 13 DISEASES OF THE SKIN (excluding uncleanliness) Number of cases known to have been treated Ringworm - (a) Scalp 1 (b) Body 5 Scabies 2 Impetigo 9 Other Skin Diseases 529 Total 546 17 18 Of the 546 cases of skin disease shown in Table 13 the following were treated in the school health clinics SKIN DISEASES TREATED IN SCHOOL CLINICS, 1960 Impetigo 7 Sores 6 Warts 365 Eczema 7 Athletes Foot 38 Sweat-Rash 8 Boils 5 Papular Rash 10 Acne 11 Ringworm 2 Herpes 6 Scabies 2 Spots 5 Dermatitis 2 TABLE 14 CHILD GUIDANCE TREATMENT Number of cases known to have been treated pupils treated at child Guidance Clinics 301 TABLE 15 Number of cases known to have been treated Pupils treated by speech therapists 174 TABLE 16 OTHER TREATMENT GIVEN Number of cases known to have been dealt with (a) Pupils with minor ailments 72 (b) pupils who received convalescent treatment under School Health Service arrangements 27 (c) Pupils who received B.C.G. vaccination 892 (d) Other than above Debility 78 Nervous Disorders 3 Respiratory Disorders 57 Other conditions 73 Total 1,202 19 TABLE 17 DENTAL INSPECTION AND TREATMENT (1) Number of pupils inspected by the Authority's Dental Officers:- (a) At Periodic Inspections 8,784 (b) As specials 1,131 Total 9,915 (2) Number found to require treatment 7,032 (3) Number offered treatment 5,645 (4) Number actually treated 3,532 (5) Number of attendances made by pupils for treatment including those recorded at 11(h) 9,051 (6) Half days devoted to: (a) Periodic (School) Inspection 82 (b) Treatment 1,043 Total 1,125 (7) Fillings: (a) Permanent Teeth 5,525 (b) Temporary Teeth 882 Total 6,407 (8) Number of Teeth filled: (a) Permanent Teeth 4,701 (b) Temporary Teeth 722 Total 5,423 (9) Extractions: (a) Permanent Teeth 907 (b) Temporary Teeth 2,570 Total 3,477 (10) Administration of general anaesthetics for extraction 1,409 (11) Orthodontics (a) Cases commenced during the year 82 (b) Cases carried forward from previous year 31 (c) Cases completed during the year 15 (d) Cases discontinued during the year 1 (e) Pupils treated with appliances 73 (f) Removable appliances fitted 103 (g) Fixed appliances fitted (h) Total attendances 1 840 (12) Number of pupils supplied with artificial teeth 25 (13) Other operations: (a) Permanent teeth 793 (b) Temporary teeth 597 Total 1,390