WAL56 BOROUGH OF WALTHAMSTOW Committee for Education REPORT of the DIVISIONAL SCHOOL MEDICAL OFFICER for the year 1962 MELVILLE WATKINS, M.R.C.S., L.R.C.P., D.P.H. DIVISIONAL SCHOOL MEDICAL OFFICER BOROUGH OF WALTHAMSTOW Committee for Education REPORT of the DIVISIONAL SCHOOL MEDICAL OFFICER for the year 1962 MELVILLE WATKINS, M.R.C.S., L.R.C.P., D.P.H. DIVISIONAL SCHOOL MEDICAL OFFICER CONTENTS Staff 6 Clinics 8 Articles:- " The Changing pace of Physiotherapy " by Miss H. Garratt, M.S.C.P. 9 "Psychiatric Social Work" by Miss A.M. Lacquer, A.A.P.S.W. 12 "Orthoptics ' by Miss M.C. IVheeler, D..B.0. 14 ' Speech Therapy by Miss J. A. Rasor; L.C.S-.T., and Mrs. C-S. Yorke, L.C.S.T. 15 The Walthamstow Chiropody Service" by R.J.King, M. Ch.S. 18 Special Schools 19 Special Classes 25 Specialist Clinics 28 Statistical Summary 33 INDEX B. C. G- Vaccination 44 Child Guidance Clinic 28,41 Chiropody 37 Clinics 8 Colour Vision 36 Committee Members 3 Convalescence 43 Co-operation of Parents 36 Dental Treatment 32,38 Diphtheria Immunisation 44 Ear. Nose and Throat Clinic 30,29 Educational Psychology 29 Employment of children 37 Eye Clinic 30,39 Foot Inspections 37 Handicapped pupils 45 Immunisation 44 Infectious Diseases 44 Medical Examinations 40 Medical Inspection 33 Minor Ailments 37 N.S.P.C.C. 45 Orthodontic Treatment 38 Orthopaedic Clinic 30,40 Orthoptic Clinic 39 Paediatric Clinic 30,42 Re-inspections 33 School Accommodation 33 School Attendance 33 School Meals 44 Special classes 25 Special School for the Deaf 19 Educationally Sub Normal 21 Partially Sighted 22 Physically Handicapped 24 Specialise Clinics:- Ear, Nose & Throat 30 Child Guidance 28 Ophthalmic 30 Orthopaedic 30 Paediatric 30 Speech Therapy 43 Staff g Statistics 33 Tonsillectomy 36 Tuberculosis 43 Uncleanliness 37 Vaccinal Condition 30 Vision Inspections 37 WALTHAMSTOW COMMITTEE FOR EDUCATION 1962 - 1963 Chairman: Alderman Mrs. W. M. PALETHORPE Deputy Chairman: Mr. S.N. CHAPLIN, J.P. Ex Officio: The Worshipful the Mayor: Alderman Miss D. WRIGLE?;, B.A., J.P. The Deputy Mayor: Alderman E. C. REDHEAD, J.P.,M.P. Chairman of the Finance and General Purposes Committers.Alderman ROSS WYLD, O.B.E., J.P., (Deceased) Aid. Mrs. G.F.G. COWELL Aid. G.R. LOWTON, J.P. Coun. Mrs. E. L. BALDWIN Coun. Mrs. r. COLIN Coun. J.H. HAMMOND Aid. G.S. MACE Aid. W.F. SAVILL Aid. A.F. WHICHER Coun. F.J. SILVESTER, B.A. Coun. G.R. SMITH Coun. Mrs. C.E. STANNARD nominated by the Local Education Authority: County Aid. Mrs. L. P. BAILEY, O.B.E. , J. P. Mr. S-N. CHAPLIN, J.P. Co-opted Members: The Rev. C. E. DAWES Mr. L. V. HEAD, J.P. Mr. R. LAMB Canon J.J. WALSH, D.D. Mr. A. WATSON, M.B.E. Miss D.E. WYLD Borough Education Officer: E.T. POTTER, B.Sc. , J.P. 4 To the Chairman and Members of the Walthamstow Committee for Education. Madam Chairman, Ladies and Gentlemen, During the year the work of the School Health Service continued to extend but there were no major innovations in 1962. One event of importance was the introduction of Regulations (under the Professions Supplementary to Medicine Act of 1960) for the State Registration of medical auxiliaries. The importance of the part played by these auxiliaries in the School Health Service is not everywhere realised and I felt that the time was appropriate to include in this report some details of the good work they are doing for the schoolchildren of Walthamstow. We had not been able to appoint a dental auxiliary but hoped that, as more of these officers were trained it would be possible for one to be allocated to our Dental Clinic to relieve to some extent the chronic and continuing shortage of dental surgeons. Dental auxiliaries must work under the supervision of a fully qualified dental surgeon when they are permitted to extract deciduous teeth and to perform simple fillings, scalings, polishing, topical application of medicaments, and to give advice on oral hygiene. We also received during the year from Dr. Stewart the statistically analysed results of the Survey carried out on the physical development (height and weight) of schoolchildren, for which Walthamstow was one of the sampling areas (a table has been included in the statistical portion of this report). It has been known for several years that, at all ages, the children of today are both taller and heavier than were their predecessors of even a decade ago and this survey was undertaken to provide accurate and up to date figures to assist the County Architect in making appropriate allowance in the design of schools, size of desks etc. Besides providing an accurate measure of the average heights and weights at ages from 5½ to 12½ years the results also indicate the proportion of children at each age who are larger or smaller than average. On the whole comparison of the Walthamstow results with those for the L C.C. area in 1959 show slight advantages in height and weight to the Walthamstow children of a similar size to those found in some of the better L.C.C. divisions' and this suggests that, as we hope, the physical environment of Walthamstow is equally above average. With the approval of the Committee for Education a start was made on extending the school immunisation programme, previously confined to diphtheria and B.C.G., to include active immunisation against Tetanus. Essex is one of the areas where the germ Claustridium tetani is commonly found in the soil and, though comparitively rare, tetanus (Lock Jaw) once contracted is often fatal so that, as a precaution, children who sustain a 'dirty' wound, even quite a minor one, have to be given Anti Tetanus serum. 5 This is prepared from horse blood and often produces quite severe reactions, so that much unnecessary suffering is avoided if children are actively immunised with Tetanus Toxoid, which does not produce adverse reactions and makes the use of serum unnecessary. More time was devoted to Health Education, a subject increasingly recognised as of growing importance in preventive medicine and the promotion of positive health. Circular 3/62 of the Ministry of Education (and 6/62 of the Ministry of Health) on Smoking and Health issued on March 12th, 1962, drew attention to the need for more health education in a 'fresh and positive effort to discourage smoking amongst children and to prevent the formation of the smoking habit' . With the approval of the Walthamstow Committee for Education we have made, and are continuing to make, efforts to publicise the dangers of smoking especially among schoolchildren, but some limitation is imposed by the fact that the staff of the Department are already fully extended on existing work. We are grateful for the help, most willingly given, by the County Health Education Organiser, but with thirteen health areas to cover besides Central Office work, the time he has been able to devote to Walthamstow is less than we should have wished. Health Education has now attained a degree of imprtance and is so time consuming that consideration should be given to appointing staff primarily for the purpose. I wish to express to the Chairman and Committee for Education my thanks for their continued encouragement, to acknowledge the help and loyal support of all members of the staff of the Department and to thank those who have contributed to this report. I am. Your obedient Servant, M. WATKINS Divisional School Medical Officer. 6 STAFF OF THE SCHOOL HEALTH DEPARTMENT - 1962 Divisional School Medical Officer and Medical Officer of Health M. WATKINS, M.R.C.S., L.R.C.P., D.P.H. Deputy Medical Officer of Health and School Medical Officer: G.H.G. POOLE, M.B., B.S., D.(Obst.) R.C.O.G., D.P.H. School Medical Officers Miss C.P. Dooley, L.R.C.P., and S.I., D.P.H. Mrs. M. Edwards, M.B., B.Ch., C.P.H., (part-time) Mrs. J.H.W. Newman, M.B., Ch.B., D.(Obst.) R.C.O.G., D.P.H. (part time) Miss J.P. Werren, M.B., B.S., D.C.II., D. (Obst.) R.C.O.G. Specialist Part-time Medical Officers (Appointed by Regional Hospital Board): Ear, Nose and Throat Surgeon: A.N. Cammock, M.B., B.Ch., D.L.O. Ophthalmologist: Miss I.D.R. Gregory, M.B., Ch.B., P.R.C.S., D.O.M.S. H.Ho., M.R.C.S. .L.R.C.P. ,D.L. 0. ,D.O.M.S. Orthopaedic Surgeon: K. Dalliwall, M. R. C. S. ,L. R. C. P. Paediatrician: E. Hinden, M.D.,M.R.C. P. Psychiatrists. Mrs. H. Gillespie, M.R.C.S.,L.R.C.P. Miss R. Hoffman, M. B., Ch.B., D. P. M. Dental Surgeons: Mr. G.P.L. Taylor, L.D.S. (Area Dental Officer) Mrs. H. Blake, L.D.S. (from 20.9.62) (c) Mr. P.B. Christie, L.D.S. (c) Mrs. A.M. Culloty, L.D.S. (c) Mr. R. Hyman, L.D.S. Mr. W. Landes, Stat. Exam. (part-time) Mr. D.R. Minchom, L.D.S. (c) Mr. T.A. Norcl5ffe, L.D.S. (from 1.1.62) (c) Mrs.D. Paxton, L.D.S. (from 20.8.62) (c) Mr. R.V. Tait, L.D.S., Orthodontist (part-time) Mr. R.J. Winkworth, L.D.S. (from 14.2.62) (c) (c) Contractor Health Visitors/School Nurses (part-time to School Health Services): Miss M. Smith (Superintendent) (to 30.9.62) Miss C. Oldham (Superintendent) (from 1.11 62) Miss R.M. Adalian (part-time) Miss D. Legg Miss J. Baldwin (from 28.8.62) Mrs. E. Levis (part-time) Miss R. Boyd Miss M. Loughton Miss E. DuRandt Miss C. Moseley Mrs. E.M. Geary Miss J. M. Palmer Mrs. J.L. Haynes (part-time) Mrs. M. Saywell Miss E.A. Kenny (to 14.1.62) Mrs. A.0- Vandy Mrs. D.E. Lambert (part-time) Miss M.E. Waghorn (All the above are S.R. N. ,S. C. M., H. v.Cert.) 7 School Nurses: Mrs. A. Dunford, S.R.N. Mrs. B. Jones,S.R.N.(to 7.6.62) Mrs. M. Leach,S.R.N. Clinic Nurses: Mrs. J.A. Gwilliams, S.R.N. (to 3.3.62) Educational Psychologists: Miss E.M. Smith, M.A. Psychiatric Social Workers: Miss A.M. Laquer Miss J.D. Ford Speech Therapists: Mrs. C.S. Yorke, L.C.S.T. Orthoptist: Miss M.C. Wheeler, D.B.O. Play Therapists (part-time): Miss F. Salzberger Physiotherapists: *Miss H. Garratt, C.S.P. Mrs. C. Penny, S.R.N.,S.C.M. (from 3. 9. 62) Mrs. B. Tasker,S.R.N.(from 26.11.62) Miss I.E. Turner,S.R.N.(to 30.9.62) Mrs. G. Cook, S.R.N. (from 2.4.62) Miss A.M. Marshall, B.A. Mrs. P.A. Pearmain Miss J.A. Rasor, L.C.S.T. Dispensing Optician: Mrs. A. Suckling, I.O.S.C. Mrs. B. Forryan *Appointed by Hospital Management Committee Dental Attendants (part-time to School Health Service): Mrs. D. Allen (part-time) (to 24.7.62) Mrs. S. Dewey Miss G. Hutchins Miss N. Hutchinson Mrs. M. Wright Miss E. Weatherill (Dental Clinic Clerk) Dental Technicians (part-time to School Health Service): Mr. G.H. Higgins Mr. G. Allen Administrative and Clerical Staff: Mr. F.J. Aylward (Senior Administrative Assistant) Mr. G.J. Bradley Miss M. Game Miss V. Jennings Mrs. M.R. Leeper Mr. G.B. Martin Mr. R. Newman Mr. R.T. Prudden Mr. A.T. Wade Mrs. P. Wells Mrs. E. Wood SCHOOL CLINICS Aura I Monday 2 p.m. - 4 p.m. Town Hall Child Guidance Monday to Friday 9 a.m. - 5 p.m. Child Guidance Clinic, Old Monoux School, High Street, E.17. Dental Monday to Friday 9 a.m. - 4.30 p.m. Town Hall Saturday 9 a.m. - 12 noon Town Hall Monday to Friday 9 a.m. - 4.30 p.m. Priory Court Saturday 9 a.m. - 12 noon Priory Court Monday to Friday 9 a.m. - 4.30 p.m. Silverdale Road Monday to Friday 9 a.m. - 4.30 p.m. West Avenue Chiropody Tuesday By appointment Town Hall,Low Hall Lane, Priory Court, West Avenue and Silverdale Road. Minor Ailments Monday, Wednesday, Friday, Saturday 9 a.m. - 12 noon Town Hall Tuesday 9 a.m. - 11 a.m. Silverdale Road Monday, Thursday 9 a.m. - 11 a.m. Low Hall Lane Massage & Sunlight Monday to Friday 9 a.m. - 5 p.m. Wingfield House School Ophthalmic Monday (Alt.) 9 a.m. 12 noon ) 2 p.m. 4 p.m. ) Tuesday 2 p.m. - 4 p.m. ) Wednesday (Alt.) 9 a.m. - 12 noon ) Town Hall Thursday 2 p.m. - 4 p.m. ) Friday 2 p.m. - 4 p.m. ) Saturday (Alt.) 9 a.m. - 12 noon ) Orthopaedic Monthly (Tuesday) 1.30 p.m. - 4 p.m. Wingfield House School Orthoptic Monday 9 a.m. - 12 noon ) 2 p.m. - 4 p.m. ) Wednesday 9 a.m. - 12 noon ) Town Hall Thursday 2 p.m. - 4 p.m. ) Friday 9 a.m. - 12 noon ) 9 Paediatric Thursday (Alt.) 9 a.m. - 12 noon Town Hall Speech Therapy By appointment Old Monoux School and Wingfield House School Immunisation Wednesday 2 p.m. - 4 p.m. Town Hall THE CHANGING FACE OF PHYSIOTHERAPY Contributed by Miss H. Garratt, M.S.C.P. As long ago as 1920 the Society was granted a Royal Charter and even then State Registration was one of it's main objects, and certainly in 1962 that seems many moons ago. At intervals during these years the clause has faded into a mere hope rather than fact. Yet. despite all setbacks State Registration has now become a definite reality and the first register is about to be compiled. What of the changes in disabilities and treatments at the Physiotherapy and Orthopaedic Clinicl Some orthopaedic conditions such as Progressive Muscular Dystrophy and Cerebral Palsy, to take only only two examples, are equally prevalent today as in the past, there still being no known cure, although research into these distressing complaints is going on. Years ago Progressive Muscular Atrophy was rather considered to be a contra-indication to physiotherapy but nowadays, although this is a progressive disease, one can hope to keep the child on it's feet a little longer and prevent gross deformities by graduated exercises. Children suffering from Cerebral Palsy had to cope with far more splintage than at the present time. Certain operations have been found most beneficial such as elongation of the tendo achilles when the child walks on it s toes, and the tenotomy of the adductions to correct the typical scissor leg" deformity in severe cases. On the contrary the Median Stoffel operation for the spastic arm, which at one time was considered an essential part of the orthopaedic programme has now faded into past history. A disease which was very common at one time was Rachitis or Rickets - children were crippled by gross deformities, their emaciated bodies showing the typical rickety rosary' . Orthopaedic hospitals had many cases for osteoclases and osteotomies the operations for severe bow legs and knock knees. Today a case of rickets is rare. 10 Although the number of cases of Anterior Poliomyelitis has declined to a spectacular degree following immunization a few cases present themselves. Electrical stimulation has always played an important part in the treatment of this condition especially for muscle testing and a great innovation over the last few years has been the Progressive treatment Unit including the depolarized galvanic current which only acts on denervated muscles, the phenomena of leakage through to normal muscles not occuring so readily. Consequently this has saved the physiotherapists time and is much more comfortable for the patient. The clinic used to have vast numbers of flat feet cases, but in Walthamstow recently the percentage of postural and structural scoliosis is far in excess of all foot deformities. In certain localities including this area conditions of the chest such as asthma and bronchiectasis have increased in numbers over recent years - but with special breathing exercises and postural drainage a good proportion improve, especially when combined with the administration of various drugs to reduce spasm. Radiant heat and infra red baths are still prescribed, but actino therapy has fluctuated in popularity over many years it's merits still being a controversial subject. Very few children are now ordered ultra violet light, whereas some ten to twenty years ago the numbers were so great that a waiting list resulted. Although not the infallible panacea for all ills, certain conditions do seem to respond favourably to this form of treatment, e.g., skin conditions with few reservations destruction of bacteria on the surface, the ultra violet rays increasing the resistance to skin infection. The tonic effect is well known, and the action of the rays on the ergosterol in the skin forming vitamin D plays an important part in the treatment of some diseases. Prom experience some chest troubles are often diminished in frequency after a course of general irrad iation. The overall picture of treatment over the years is I think rather less massage and far more re education and exercises Unfortunately as the scope for physiotherapy grows and corres pondingly the number of patients, the number of physiotherapists remains inadequate so that departments do not have their full complement. Whether it is given for definite disabilities or in a prophy lactic measure physiotherapy has always been a challenge but most of all a very real response to human need. It will be appreciated that only a few types of the many disa bilities have been mentioned therefore one or two progress reports on specific children are given in more detail. S.C. Born a normal child in 1943. this girl was admitted to hospital at twenty months following a cerebro vascular accident resulting in a left sided hemiplegia, a large atrophic lesion in the whole of the right hemisphere of the brain was indicated. 11 In 1955 she was sent to a residential school, but because of the marked deterioration in her behaviour she was discharged home after five years. At the age of eleven she came to the physiotherapy clinic for treatment, because she had been admitted to the School for Physically Handicapped. At this time it was noted that the left hip was dislocated so at the end of 1960 she was admitted to hospital for operations of hip and foot. She returned to the clinic in May 1961 not being able to stand or walk but being confined to a wheelchair. Fortunately the girl was co-operative and within a few weeks was standing and taking steps with help. To help strengthen the weak leg she was supplied with a walking caliper and soon she was walking quite well with the aid of sticks. Subsequently she was able to discard the caliper altogether by the end of 1962 and is now using only one stick for long distances. P.O. A 2½ month premature baby and weighing only 3 lbs P. was born with cerebral palsy affecting all limbs especially the legs. She also had been in a residential school from 1953-1958. When she first attended the clinic in 1958 she was walking very badly on two sticks having gross flexion of both knees which were not corrected by walking calipers and night splints. Early in 1959 she had a partial tenotomy of the hamstrings and within three months was on intensive physiotherapy at the clinic, and her progress was quite spectacular. Since mid 1960 she has dispensed with the calipers and she can walk quite well without sticks although again for long distances and in icy weather she resorts to sticks. Instead of being conveyed to school by the school transport she now comes on her own. L.P. This nine year old girl contracted anterior poliomyelitis in August 1959 which affected both legs, left arm and abdominal muscles. Attending twice weekly for massage and re-education since mid 1960 when she was wearing a walking caliper on the right leg, she was able gradually to leave off the caliper and has been without it completely since the end of 1961. She continues to make satisfactory progress with only a slight residual limp. S.S. At the beginning of 1961, this girl at the age of twelve started a course of remedial exercises because of quite a marked kyphoscoliosis and pigeon chest. At first her progress was slow and operative treatment was discussed,but the parents were against this procedure, and pleaded that she might continue the exercises. Throughout her attendance a series of x-rays were taken which revealed that by the middle of 1962 her curvature was much less severe and by the end of 1962, the orthopaedic surgeon stated that her back was straight. Nevertheless she will continue exercises to maintain her good posture. 12 A.S. In May 1960 this six year old boy was admitted to the School for Physically Handicapped Children with a history of recurrent catarrhal bronchitis with broncho spasm, and nasal catarrh with varying amounts of catarrhal deafness. During the same month he was put on a course of breathing exercises and postural drainage. He made a very gradual improvement at first, but this was main tained and later he progressed so satisfactorily that by Easter 1962 he was able to return to ordinary school. G.B. Born by Caesarian section at Thorpe Coombe in 1948 with severe bilateral talipes equino varus this boy had both feet splinted from two days old. When he started to walk he was supplied with wedged shoes and special night splints. After several manipulations as an out patient he was admitted to hospital in 1952 for open elongation of the tendo achilles followed by application of Plaster of Paris. He was transferred to the Physiotherapy Clinic in 1953 when he was fitted with surgical shoes and attended regularly for exercises. This type of deformity is often most disappointing to treat because of the risk of relapse due to the increasing deformity of bone structure as the child grows. However, he made excellent progress the mother was always most co operative, and made sure that the exercises were carried out at home. In 1961 he was able to go into normal shoes, and was finally discharged in September,1962. PSYCHIATRIC SOCIAL WORK Contributed by Miss A.M. Laquer, A.A.P S.W. The Psychiatric Social Worker s influence on child health and preventive mental health, we hope is considerable. Ours is the case work approach that is, seeing and treating the family as an entity rather than child guidance in a narrow meaning. We are dealing with' the parents' difficulties and problems, although they may see them only in the light of the children's problems, more often than not the two are so closely connected that one can hardly ever keep them entirely separate. The kind of case work we are doing now has been practised fairly widely for a number of years and great use is being made of the understanding of the use of relationship between the social worker and her or his clients. The worker s aim is to make a relationship with the client, and in the context of this relationship to discuss and work through some of the clients' feelings and attitudes which are affecting adversely inter familial relationships, and the clients' ability to function comfortably as a person. These feelings and attitudes have developed in the client in response to his or her experience of life from earliest childhood. 13 For example, a woman who, as a child, always felt her younger brother was preferred to herself, may have difficulty when adult in bringing up her own son, because though unaware of it, her attitude to him is coloured by her early resentment of her favoured sibling. As she becomes aware of this in the course of her contact with the worker, she is able to see herself as a person more clearly, and her handling of him will change. The workers rule is to help the client to see for herself. If, in this situation, advice was given, it would be easy for the client to see the worker as just like her own mother, putting the boy s interests first, so that her feelings of resentment would be increased rather than diminished, rendering it impossible for her to carry out the advice in the right spirit, if at all. The growing insight into the need for preventive mental health has been clearly recognised by the medical profession and psychiatric social workers, including ourselves, have started to help other workers in the field to gain greater insight into what we call family relationships. One of our contributions has been the work with Health Visitors in regular groups where actual cases which present definite mental health problems are discussed. These group meetings are of an informal kind and not only individual cases but general problems, to which Health Visitors have even greater access in the community at large than we do. are discussed. This kind of group work is extending everywhere because it is now understood and accepted, that in all field's of social work, to succeed in helping people it is essential to be aware of underlying personality problems which may affect their ability to accept and profit by the help offered. The group discussions are a means by which workers in different fields can discuss basic factors and gain deeper insight and understanding of them. One other contribution in this field is the two talks I have been asked to give every year for the past few years at the Dagenham training course for Health Visitors, where it is my policy to let the students know in which way we work and how cooperation between Health Visitors and Child Guidance clinic can be achieved and maintained. I am of course, still supervising and training students who are doing their practical work in the Child Guidance Clinic, and all seem to enjoy their work with us greatly. All have been successful in gaining the Certificate. Perhaps I should add that all students who are accepted for the Mental Health Course are fully qualified Social Workers, who must have had several years experience of social work in various fields. 14 As to current development or general trend of importance within our profession, I should add that more and more Psychiatric Social Workers are being used in the training schemes of social workers, e.g. Younghusband courses, the generic case work course, etc. ORTHOPTICS Contributed by Miss M.C. Wheeler, D.B.O. Orthoptics is the treatment of squint with and without the use of surgery. All patients have a routine refraction, and glasses are prescribed if necessary by the ophthalmic surgeon. Some difficulties are experienced when the patient is 'set against' wearing glasses or if he is very young. However, perseverence and co-operation at home can overcome this. Alternatively the patient with the high refractive error is usually delighted with his glasses and his personality will change accordingly. Patients are then referred to the orthoptic department. Occlusion (or patching) is the most well known part of the treatment when the-occlusion is put onto the good eye to enable the amblyopic eye (low vision due to disuse) to get better. This can cause great difficulties and upsets to the patient, especially if he is very young, or the anplyopia is very bad. However, with a firm hand and co operation at home ensuring that the occlusion is always worn, the vision will improve and both patient and parent will be delighted. Orthoptic exercises form the other part of the treatment and these are normally very popular, as it merely entails looking at 'coloured pictures and thus keeping the patient's attention while the various exercises are executed. Surgery is required on some cases of squint and is advised and carried out by the ophthalmic surgeon. The much discussed psychological trauma' of young patients in hospital can come into effect here. Usually however, the short stay of a week, although sometimes difficult at the time, is soon forgotten and there are no ill effects whatsoever. The pleasure and satisfaction gained by both patient and parent when the squint is cured, and the self confidence gained by the patient himself far outweighs any risk of trauma. The basis of success of orthoptic treatment is to get the patient young, when with the co operation at home a complete cure can be effected. The older patient may not be able to obtain a functional cure, but a 'cosmetic' cure can always be brought about (by surgery) to prevent any psychological or inferiority complexes. 15 Glasses may or may not be required after treatment but attractive frames are now made t o suit everyone and they can be worn easily by anyone. SPEECH THERAPY Contributed by Miss J.A. Rasor, L.C.S.T., and Mrs. C.S. Yorke, L.C.S.T. Speech Therapy as we know it today, is a product of this century. In 1906 Manchester opened its first classes for stammerers and in 1911 an Instructor in Voice Production was appointed at St. Bartholomew s Hospital. 1913 saw the establishment of a clinic at St. Thomas's Hospital under the auspices of the Central School of Speech Training. By 1918 the L.C.C. had established four school centres for stammerers. Walthamstow was not far behind as in 1925 classes for stammerers were held on two afternoons a week, first at Marsh Street, and then at Mission Grove School. By 1934 two professional associations had been formed. The British Society of Speech Therapists and the Association of Speech Therapists. In keeping with this development a report was submitted to the Walthamstow Committee on 'Stammering and Other Speech Defects' and as a result, in 1936 a qualified Speech Therapist was appointed. She was faced with 254 children who had been recommended for treatment and group work was considered the answer. Each group attended twice weekly for one hour, the school bus bringing the younger children. Classes were discontinued at the outbreak of war but recommenced in 1941. In 1944 the two professional bodies were united as the College of Speech Therapists and a three year training and a set syllabus was agreed. Meanwhile in Walthamstow numbers were growing tremendously and it was not until 1947 when a second therapist was appointed that moves were made towards more individual therapy. 1955 heralded a great change. It was at last possible to arrange individual appointments for the majority of children. As they are today the Walthamstow school clinics are typical of many in the country, and the following cases may serve to illustrate the work and its link with other Child Welfare Services. N.C. This girl had a paralysed soft palate giving the type of speech that is typical of the cleft palate patient, including defective articulation and excessive nasal tone. Articulation improved after treatment, but tone of voice was still defective. 16 She was therefore referred to a plastic surgeon who performed a pharyngoplasty. Following further Speech Therapy normal voice was obtained and she was discharged cured one year after the operation. G.A. This boy, aged 5 years, suffers from ectodermal dysplasia and was referred to the Speech Therapy Clinic for treatment of dyslalia. This speech defect is linked to his general condition as his teeth have failed to develop. He was therefore referred to the prosthetic department of the London Hospital and fitted with dentures. He is now expected to make good progress with Speech Therapy as many sounds can be obtained with greater ease. L.B. L. is a boy, aged 5 years who suffers from a high frequency deafness, he wears a hearing aid, and has been attending a London Hospital for auditory training. He was transferred to the Speech Clinic when he commenced school. He is responding well to auditory training, articulation practice and language stimulation. R.A. R. was referred with a severe stammer at the age of 8. The stammer had developed when parents drew attention to and tried to correct hesitancy in speech at 4 years. The stammer was aggia'ated when he moved from Ireland to London as other children could not understand him. Individual treatment was given at first, followed by group treatment when he had made sufficient progress. He received weekly treatment for 3 years, monthly treatment for a year followed by occasional observation until he left school. Speech is now stable and there has been no return of stammering. S.M. This is a case of delayed language development, referred by the Welfare Clinic prior to the child commencing school. At 4 years when he first attended, he used only a few single words but expressed himself by gesture. This excellent gesture language was an important factor in the lack of spoken language and once we refused to accept this, language progressed. After two months Intensive language stimulation he was making a real effort to repeat words and within another month he was using single words and some phrases spontaneously. Sentences deve loped within the next eight months and before leaving the clinic he had started to read. G. aged 7 years, seen on a school visit, was referred because of her use of a lateral s. Investigation revealed a high frequency deafness so arrangements were made for her to receive auditory training, using a specialised hearing aid. Along with this training she received individual coaching in arithmetic and reading and Speech Therapy for the correction of the defective sound, all of which permitted her to make up lost ground and maintain her correct standard. 17 J., a little boy with a language disorder and a physical handicap, due to brain injury, was admitted to a special school. His particular difficulty was the inability to put names to objects and formulate and express his thoughts in words. Through contact with the class teacher, it was possible to co-operate and co ordinate presentation of material to be learned, and to tackle the feared reading situation by indirect methods. This approach combined with special training to surmount the nominal dysphasia allowed J. to feel master of his difficulty and the increased confidence he derived permitted him to face rather lengthy treatment of the remaining language disorder. M., a boy in his teens, was referred for psychiatric help and Speech Therapy. Subsequent to treatment at the Child Guidance Clinic he attended the Speech Clinic for treatment of stammering. Individual help aimed at establishing confidence in his speech mechanism and in his ability to use it. He did in fact respond extremely well and among other achievements to his credit he entered a poetry speaking competition at his school after only eight visits to the clinic and was very well placed. His mounting confidence paved the way to further success to the point where speaking situations no longer held any fear for him. P., aged 6 years, was referred on account of his almost unintelligible speech and unusual voice. He was in fact a chronic mouth breather because of the gross enlargement of his adenoids in addition his uvula was deformed to the extent that it restricted the movement of the soft palate, in consequence his voice lacked nasal tone. He was referred to the E.N.T. clinic and following treatment there he returned to the Speech Clinic for correction of the dyslalia and the persisting voice defect. The latter was due to habit, the soft palate having become lazy. Exercises to stimulate vigorous movement of the palate corrected this laziness and normal voice was soon achieved. Articulation games and exercises were no longer difficult for F. and within nine months of his being referred to the clinic he was discharged with normal voice and speech. 18 THE WALTHAMSTOW CHIROPODY SERVICE Contributed by R.J. King, M.Ch.S. Walthamstow Chiropody Service started in 1931, being the second municipal clinic in the country, and from the start provided special sessions for children, as it was realised at that early date the importance of chiropody to the child pop ulation. Situated in various parts of the borough we have five clinics, each has an allocation of schools to look after, the schools making appointments direct to their clinic, thus every child has an appointment, and is seen at the stated time, thereby avoiding wasting too much school time. We have a staff of six full time chiropodists, plus four part time, being the only Health Area in the county having a full staff, and the only area giving a full chiropody service to all age groups. The weekly childrens clinics are well patronised, 2,351 treatments having been given last year. A large proportion of these children attend with verruca pedis (foot warts), and the growing amount of corns, various types of nail troubles, plus a great many allied conditions. Our clinic acts as a clearing house, as we are often the first to examine their feet, and are able to pass on the conditions that should be seen by the doctor. The footwear of a large section of the children leaves much to be desired. Great harm is being caused by children following the example of adults, and I am sorry to say condoned by their parents. There seems to be a tendency for a large section of parents to abide by the judgement of the child when buying shoes. Still the greater curse in footwear is the court, slipper or casual shoe worn by the girls, and now the pointed toe shoe for boys, is providing us with more patients and in both the boys and girls are producing, hallux valgus, overlapping toes, retracted toes, painful heels, and a damage to nail plates. We must not overlook the trouble caused by pressure from stretch man made fibre socks and stockings, these are extreme ly strong and exert back pressure on the toes. I should also point out that the wearing of correctly fitted shoes and socks in childhood will help to produce good feet, but this does not give immunity in later life if the rules of good fitting shoes and stockings are broken. 19 SPECIAL SCHOOLS WILLIAM MORRIS SCHOOL FOR THE DEAF. Mr. K.S. Pegg, Headmaster. reports as follows - The school re opened in January 1962 with 49 on roll, and during the year 8 children were admitted and 1 partial hearing girl left to obtain employment in the Bank of England Printing Works. Children were drawn from the following areas DEAF PARTIAL HEARING TOTAL Boys Girls Boys Girls S.E. Essex Thundersley - - 1 - 1 South Essex Upminster - 1 - - 1 Forest Wanstead & Woodford 2(2) 1 1 - 4 Nazeing - - - 1 1 Harlow 1 1 1 1 4 Loughton - - 3(1) - 3 Chingford - - - 1 1 Waltham Abbey - - 1(1) 1 2 Barking 2(1) 1(1) - - 4 Dagenham - - 2 - 2 Ilford 3 1 - 5(1) 9 Leyton 2 4(1) 2(1) 2 10 Romford 2(2) - 5(1) 1 8 Walthamstow 1 2(1) 1 2 6 13 11 18 14 56 (Figures in brackets indicate children travelling by public transport and are classified as follows:-) Under 5 5 -11 11-16 Total Deaf Boys 2 6 5 13 Girls 5 3 4 12 Partially Deaf Boys - 10 8 18 Girls - 8 5 13 7 27 22 56 20 "There is a growing need for the establishment of a diagnostic clinic within the school. At the present, children from our catchment area attend the Audiology Unit which is attached to the Royal National Throat, Nose and Ear Hospital, Gray's Inn Road. Hearing Aid repairs, ear moulds etc., are also dealt with at the centre and every help and encouragement has been extended to this school by the Director and Staff. It should not be necessary however, for parents to take children, in many cases very young children, from all over the catchment area to this unit when such a centre could be established locally. There is a need too for the provision of a special observation class, for those children whose needs regarding language development and communication skills cannot be assessed without a period of observation. 'After Whitsun the two reception classes were transferred to specially prepared and equipped classrooms at the Thorpe Hall School. The children both deaf and partially hearing now have the opportunity of mixing with hearing children at play and have settled down very happily. I must express my appreciation to Miss Cobbledick the Headmistress and to the Staff of the Thorpe Hall School for the manner in which they are helping to ensure the success of this experiment. The number of visitors to the school has increased, and tape recordings have been prepared which show the effects of varying degrees of hearing loss on speech, the acquisition of language and some of the difficulties experienced by the users of hearing aids. Binaural listening experiments are still in progress and we are continuing to co operate with Post Office Engineers Depart ment in an attempt to find the most suitable material for hearing aid cases. New developments in the education of children with impair ed hearing and in the use of hearing aids and other auditory equipment in stimulating the use of even a small amount of hearing have made it necessary to reconsider the suitability of definit ions of pupils with impaired hearing. In the Ministry of Education circular of September 1962, the more positive approach to the use of residual hearing has been emphasised by the sub stitution of the term partially hearing" for " partially deaf'.' In June Mr. Taylor held a dental inspection and in October Dr. Werren conducted the medical inspection. " I have to express my thanks to all ray colleagues for their efforts on behalf of the children." 21 MARGARET BREARLEY SCHOOL FOR THE EDUCATIONALLY SUB-NORMAL. Mr. L.F. Green, B.Sc., Headmaster, reports as follows:- "The population of the school, apart from one Ilford pupil, consists entirely of Walthamstow children. At the end of the year the school had 96 children on roll. "This year has been marked by increased co-operation with parents and with the various officers who also assist our children. Mrs. Leach S.R.N., has given valuable assistance to the school by regular checks on hygiene etc., and the various clinics have continued to provide help for our children, showing a real under standing of their special problems. Despite the efforts of individual officers however, some of our problem families still constitute a serious challenge. " Dr. Poole now visits the school on the first Monday of the month to carry out routine medicals and to discuss any medical problems which arise. This has been a most valuable innovation. " The general equipment of the school continues to improve. Visits to factories and places of interest have played an important part in our educational programme. Visits to factories have resulted in the placement of at least one pupil. Other visits have been made to R.O.S.P.A. House, Fire Station, Shoeburyness, Museums, St. Pauls, the Zoo, Epping Forest, Bertram Mills Circus. The highlight was undoubtedly a visit to the House of Commons with Alderman E. Redhead, M.P., as a most sympathetic guide. " Interest in the work of Special Schools has been reflected by the number of visitors to the school. These have included the Mayor and Mayoress of Walthamstow, teachers in training. Psycho logists, medical officers, Student Health Visitors, and specially welcome were colleagues from other schools in Walthamstow. " In order for our work to be effective it is necessary to have the whole hearted support of the parents. There are signs that this is increasing. Parents are always welcome in the school and in the past year, the parents of at least 70 children have been seen by the Head Teacher and respective class teachers. "Outstanding activities during the year have included a Swimming Gala and Sports Day in conjunction with other Special Schools in Walthamstow. "Of the 16 children who left during the year, two were transferred to the Loughton Training Centre at the request of their parents whilst the rest were placed in some form of employment. Some leavers have done exceedingly well. 22 One boy has an apprenticeship at a provision merchants, another has a day release for learning a special woodwork machine and three are machinists. During the year two children were transferred to the Junior Training Centre after a period of trial at the Annexe, two boys were given residential placement, and two pupils were transferred to a Secondary Modern School. " I have to express my thanks to all those who have been such good friends of the school and specially to my own teaching colleagues who at all times have given of their best". THE JOSEPH CLARKE SCHOOL FOR THE PARTIALLY SIGHTED. Mr. G.M. Williams, Headmaster, reports as follows:- "At the end of the year the school had a roll of 49 a decrease of 7 over the previous year. During the year children from the following areas were on the school register. Essex Barking 1 Ilford 4 Basildon 1 Leyton 2 Canvey Island 1 Loughton 2 Chigwell 1 Pitsea 1 Dagenham 10 Romford 2 Harlow 2 S. Ockendon 4 Hornchurch - Walthamstow 8 Hutton 2 Woodford 1 Rainham 1 Middlesex Edmonton 2 Tottenham 3 Wood Green 1 The visual acuity (Snellen) after correction of the children attending the school is shown below. 7 children had acuity of less than 6/60 15 " " " " " 6/60 7 " " " " " 6/36 10 " " " " " 6/24 10 " " " " " 6/18 "There were 17 children with monocular vision and 5 children with additional handicaps. "The table below shows the principal defects of the children at school at the end of the year. Boys Girls Albinism 3 5 Aniridia - 1 Anisinetrophia 1 - 23  Boys Girls Cataract 11 6 Choroiditis - 1 Congenital - 1 Day blindness, dislocated lenses 1 - Iridocyclitis 1 - Myopia 6 - Nystagmus 1 - Optic Atrophy 2 2 Phthisis Bulbi 1 - Retinal degeneration 2 1 Retinitis Pigmentosa 2 - Subluxation of the lenses - 1 "As in previous years the ophthalmic supervision of the school has been well maintained. Dr. I. Gregory, M.B., D.O.M.S., made visits in June and October for the purpose of examination and has given much helpful advice. The medical staff of the Eye Clinic have made regular ophthalmic examinations and Mrs. Suckling has given ready and efficient service in the supply and repair of spectacles. The willing help and co-operation of all at the Eye Clinic has been much appreciated. " In September Dr. Werren carried out a full medical inspection of all the children in the school. In June Mr.Taylor from the School Dental Clinic visited the school for dental inspection. "Visitors during the year included the Mayor and Mayoress of Walthamstow. the School Medical Officer for the Forest Division of Essex, post graduate medical students, the Super intendent Health Visitor and Student Health Visitors. Student District Nurses, pupil midwives, qualified teachers, training college staff and students, a student sociologist and a party of students from Dr. Barnado's. "During the Whitsuntide holiday a party of twelve children under the care of Mr. Crosbie spent a week at the Isle of Wight in company with the Woodside School Camp party. This again proved to be a most instructive and worthwhile venture " In January, Miss 0. Brown commenced service in charge of the infant class, filling the vacancy caused by the departure of Mrs. Harrington. "The average number on roll during the year was 53.9 with an average attendance of 46.7. Ten children were admitted and 13 children were taken off roll. Of these three were younger child, ren, one of whom moved out of the school's catchment area while 2 transferred to Residential Schools. There were 10 children who left to employment, as follows: 24 Boys 1. Registered as a Blind Person, checker in engineering firm using braille micrometer, etc. 2. Training for career in catering. 3. Employed at a piggery. 4. Working in a timber yard. 5. Employed in store of chemists shop. 6. Employed in stores and packing department of local medical goods firm. 7. Employed as baker and attending Royal College of Bakery Girls 1. Shop assistant in florists. 2. Hair dresser. 3. Attending Secretarial Training Course, Westminster College of Commerce. "There are now 9 children of secondary school age travelling independently by public transport." "I have to express my thanks to all staff, teaching, welfare and transport for their continued efforts on behalf of the children " . WINGFIELD HOUSE SCHOOL FOR THE PHYSICALLY HANDICAPPED. Mr. G. M. Williams, Headmaster, reports ac follows:– " The school commenced on 9th January. 1962 with 92 children on roll, drawn from the following areas:- Walthamstow Wanstead and Woodford Waltham Abbey Leyton Chigwell Epping Chingford Harlow Enfield Loughton Hornchurch During the year there were 22 admissions and 1 re-admission, giving an average weekly roll of 89 children, with an average attendance of 70.7. 24 children left during the year. To other schools To employment 2 to long stay hospital schools 1 boy as garage mechanic 1 to home tuition 1 boy to a City office 3 to E.S.N, schools 1 boy to a large store 2 to Residential Schools 1 girl to routine light factory work 11 to ordinary day schools 1 girl to industrial training and assessment centre. Pour of the leavers were registered as 'disabled persons' for the purpose of employment. The average length of stay of the 19 children transferred to other schools was 3 years 2 months, and of those leaving for employment 5 years 11 months. 25 "Of the children on roll 58 received treatment by Miss Garratt in the Orthpaedic Clinic, and 18 children received speech therapy. There were 3 non-ambulent children on roll and 11 who were only partially ambulent. "Visitors to the school during the year included parties of pupil midwives from Thorpe Coombe Training Unit, one Health Visitor from Persia and one from Malaya, four post-graduate medical students, and students from five Teacher Training Colleges, of whom two spent a week on practice and observation. "The school has benefited greatly by the valued co-operation of Miss Garratt in the Orthopaedic Clinic and of Miss Rasor of the Speech Clinic. Miss Smith has made visits for the purpose of educational guidance and Mr. Harvey, Youth Employment Officer and his staff have interviewed and advised all school leavers. "Dr. Poole who is in clinical charge of the school has made regular weekly visits and Dr. Werren has also made 5 visits for supplementary medical inspection. Their ready and helpful advice has been greatly appreciated. "Mrs. Leach, S.R.N., has attended the school daily and has assisted in the general care and management of the children and has carried out audiometric testing on selected children. A total of 383 minor treatments have been given. "There has been only one staff change during the year when Mrs. Parmenter joined the Welfare Staff in early March. "The children on roll at the end of the school year were classified as follows:- Delicate 19 Physically Handicapped 67 Epileptic 3 "I would record my thanks to all staff colleagues for their continued and steadfast service on behalf of the school " . SPECIAL CLASSES Miss EM. Smith, Educational Psychologist, has contributed the following report on special classes in junior schools during 1962/63. In September 1962, a fourth special class was established at the Winns Junior School, so that a total of 62 * children have worked in these small units. Mrs. Corner, Mrs. Wilkinson and Miss Cook have continued in charge of the classes at Woodside. Blackhorse (now Higham Hill) and Mission Grove (now Edinburgh)and Mrs. Parkes was appointed to the Winns class. These four teachers must be congratulated on their year's work. Mrs. Wilkinson's retirement in July will cause a serious loss in this type of work. 26 Before the end of the school year, all the children were re tested for reading attainment and intelligence level. In reading, only four children amongst the whole group show no improvement, of these four, one has a very severe speech defect, two are obviously in need of full scale special education, and one is a very anxious unhappy boy. The amount of improvement in reading varied from an advance of a few months to one of two and a half years. Although progress in reading was maintained in all four classes, the I.Q's registered are deserving of particular comment. For two classes (Blackhorse and Mission Grove) the year has been made difficult by changes in the school environment. At Easter the Blackhorse Class, with its teacher moved to Higham Hill, while the Mission Grove Class was transplanted to Edinburgh Junior, changes necessitated by the closure of Blackhorse and neighbouring schools. It says much for the teachers of these two classes and the receiving Head Teachers that no major problems arose. However the I Q s shown indicate that the changes were not without effect. In the Woodside Class (no change) four child ren obviously needing to transfer to E.S.N. school showed a lowering of I.Q., the same picture being true for the Winns Class (no change). Here, three children showed a sufficient fall in I.Q. to indicate a Special School need. In the group which moved from Blackhorse to Higham Hill, half the children showed a regressed I.Q. (two to E.S N. level) while the group moving to Edinburgh showed a, fall in I Q. for all but four children. Some of these decreases were insignificant, but others were seriously depressed by as much as 19 points. These figures suggest two points (1) The possible adverse effect of a change of environment on children of limited mental endowment. (2) The increased adverse effect when such a change is made suddenly. Eleven children will be transferring because of age from Woodside and Higham Hill to appropriate Secondary Schools. Seven children from all classes will be transferred, if possible, to Special School. The need for these classes continues. In September 1963 there will be accommodation for only 64 children while 70 are in need of such help. * Including 5 children given temporary places. 2 foreign language children. 1 experimental placement from Deaf Centre. 1 Secondary boy 1 E.S.M waiting placement 27 SUMMARY OF RE-TEST RESULTS JUNE, 1963. Class Woodside 3rd & 4th Year Higham Hill 3rd & 4th Year Winns 2nd & 3rd Year Edinburgh 1st & 2nd Year Number of children 14 13 16 14 I.Q. Range 66-102 Average 82 " gain 19 Range 66-105 Average 86 " gain .9 Range 66 103 Average 98 " gain 1. 6 Range 66 102 Average 82 " loss 3.5 R. A. Range 7yr6m9yr.6m. Aver: 8yr.lm. gain 9mths. Range nil10yr.9m. Aver 8yr. om. " gain 9mths. Range nil8yr.6m Aver 7yr.7m. gain 9m. Range 6yr.2m. 7yr.9m. Aver 6yr.8m " gain 8mths. 28 SPECIALIST CLINICS CHILD GUIDANCE CLINIC. Dr. Helen Gillespie, Consultant Psychiatrist, reports as follows on the work of the Child Guidance Clinic:- General Comments: There has been an increase in cases referred during the year in the Walthamstow and Leyton areas. As regards reasons for referral, the figures show a disproportionate increase in the category 'Nervous Disorders' referred in the Walthamstow area. It is satisfactory to know that children of this type are being increasingly referred for treatment, and not merely those whose disorder is of high nuisance value". Since October 1962. children from the Leyton area are no longer referred to the Centre at Walthamstow, as Leyton now has its own Child Guidance Centre. We continue, of course, with the children who have already started treatment here. We now hope to be able to provide an improved service for the areas for which we continue to be responsible, that is Walthamstow, Chingford and Forest Division. Staffing: Miss Russell left at the beginning of December, to take up a residential post at one of the Richmond Fellowship Houses. She joined the staff of this clinic at its inception in 1945 as a social worker, and then took her training as a Psychiatric Social Worker from September, 1946 for one year, and worked in this capacity from then on. We wish her every success in her very interesting work. Play therapy sessions have decreased to five only per week, since Mrs. Elkan left the clinic last October. We have been unable so far to fill the vacancy for the remaining five play therapy sessions. Activities of Staff Outside the Clinic: These are expanding. Psychiatric Social Workers Miss Laquer, Mrs. Pearmain and Miss Ford are meeting four groups of Health Visitors at regular intervals of about one month. Their aim is to increase the Health Visitors' interest in preventive mental Health. The problems which arise in their work with children are discussed in the setting of the family and its relationships. Other problems discussed include those of old age and of mental illness with their family repercussions. The Health Visitors also gain more knowledge of the Child Guidance Services. The members of the group find their attitudes change as the result of the discussions, with a greater tendency to attempt to understand family and community problems before initiating or sugges ting possibly ill advised action. Attendance at these groups has been excellent. 29 Miss Laquer and Miss Marshall each give two talks per annum to Health visitors in training at Dagenham Technical College, these talks having similar aims. The training of Mental Health Students continues. Two students at a time, for six months each, carry out their practical work at the Centre, attending three times per week. During the year a student Psychologist, in training at Birmingham University, spent a month at the clinic with Miss Smith, and did some testing in schools, and two students from the Tavistock Clinic spent a month with Miss Marshall. Children Under Five: It is gratifying that this year there has been an increase in the number of children under five referred to this clinic. Our experience has always suggested that treatment in this age group holds out the best prospects of success. This impression has been confirmed as a result of our follow up enquiry, which we have carried out on 56 children seen at West Avenue Infant Welfare Centre between the years of 1952 and 1956. 56 questionnaires were sent out, and 32 replies were received. The remaining 24 children were untraceable, in spite of attempts at home visits, etc. Of the 32 children about whom information was obtained it was found that the original symptoms had persisted unchanged in only one case. they had disappeared completely in 17 cases, and partially in 12. Home behaviour was reported to be improved and satisfactory in all but one case, and school progress was said to be satisfactory in every case. Although the small numbers involved, and the high proportion of untraced cases, make it impossible to attach any statistical significance to these results, they nevertheless seem to suggest that treatment of the children in the under 5 age group is usually very rewarding. Miss E.M. Smith.. Educational Psychologist, reports as follows By the establishment in September of a fourth special class for children needing a slower learning pace and a more individual approach. 60 children from Junior Schools are being given this type of help. The selection of children for these classes, together with supervision and assessing, their progress is a time consuming but interesting part of the psychologist's work. During the year 109 visits were paid to schools, 336 children being given individual intelligence tests. 76 of these children were referred to the Child Guidance Centre, for a variety of symptoms of mental ill health. It is relevant in this connection to suggest that teachers should be alive to these symptoms and bring such children to the notice of the psychologist even when symptoms appear mild, rather than wait for some crisis of behaviour to 30 develop. The rather long waiting list for Child Guidance service should not prejudice referral, since any improvement or spontaneous adjustment can be reported if it occurs. On the other hand, it plainly limits the possibilities of psychiatric help, when referral is postponed to the later years of school life. Remedial education in basic subjects has been given by the psychologist to 13 children during the year, with a total of 230 sessions. During the Spring term a student psychologist, in training at Birmingham University spent a month at the clinic and did some testing in schools. The psychologist gave informal talks to several Parent Teacher Associations, and to groups of mothers. EAR, NOSE AND THROAT CLINIC: The weekly Ear. Nose and Throat Clinic has continued under the clinical charge of Dr. A. Cammock, M.B., B.Ch. ,D.L.O. Mrs. Leach, S.R.N., has carried out audiometry tests on 289 children and of these 89 were referred to the clinic for specialist opinion. EYE CLINIC: This clinic continues under the clinical charge of Dr. Hilton Ho. The services of a dispensing optician and an orthoptist are available to patients. ORTHOPAEDIC CLINIC, Mr. G. Rigby Jones, who had been in charge of the Orthopaedic Clinic since 1953. retired during the year, and Mr. K. Dalliwall, Consultant Orthopaedic Surgeon, was appointed in charge of the clinic. PAEDIATRIC CLINIC: The clinic contined under the clinical care of Dr. Elchon Hinden. Paediatrician to Whipps Cross Hospital, who reports as follows The work of the Walthamstow Paediatric Clinic has proceeded along the accustomed lines. The majority of the children have been referred either from the School Health Service, or from the Maternity & Child Welfare Clinics, a few are sent direct by their family doctors. All the patients are seen by appointment, and the clinic is usually fully booked. This year I would like to discuss a subject which is not of immediate interest to the school health service, though it may well become so in later years. I refer to the terrible damage done by Thalidomide to the development of the unborn child. The calamities caused by this drug have focussed attention on the whole subject of congenital deformity. The risk of a pregnancy 31 resulting in an imperfect baby has always been with us, it is a hazard which any couple starting a family in love and faith has to face. But that risk is unpredictable, and if a damaged infant should result, at least the parents' conscience is clear. This is a misfortune which has lighted on them, not retribution. This cannot be said about Thalidomide. The damage it does is not due to blind chance, it is man made, and the parents, the doctor,the chemist - in fact all society, cannot escape a feeling of guilty responsibility. This emotion has magnified the distress inevitably roused in parents by the birth of a deformed baby and so has engendered a public clamour about these stricken babies which their number hardly justifies. Thalidomide is responsible for about 400 damaged babies over the 18 months that it has been on sale in this country. Of these, about 240 have survived and will need long term treatment and education using these words in their broadest sense. But how does this number compare with the 1,200 Mongols, or the 750 children with spina bifida, paralysed below the waist who are born every year? In fact, the total of all major congenital deform ities comes to about 1% of all babies born, that is 7,500 severely affected children each year. Even though half of them soon die,the community of seriously crippled children grows by 3,500 yearly. Against this background, the once for-all addition of 240 Thalidomide casualties is not a great one. It is, of course, the knowledge that these need not have happened which is so disturbing. I have written above that the risk of congenital deformity is unpredicatable. This is true for the individual family not for society as a whole. Dr. Frazer Roberts, the eminent geneticist, has pointed that the the overall figure for serious deformity is as high as 1.40. When we think of the staggeringly complex development the foetus must needs undergo, and the risk of death by drowning, suffocation or apoplexy he has to surmount at the moment of birth, the figure does not seem large, but in terms of human heart ache it is enormous. At the moment we do not know how to avoid it. It is a fact, though only cold comfort, to the desolated families, that Thalidomide has raised the chance of congenital deformity by less than 5%. I should like to thank the school doctors for referring the children to me, and the family doctors for authorising the refer rals. I should also like to thank my colleagues at Whipps Cross Hospital, Dr. P. Tettmar, radiologist, and Dr. W W. Walther, pathologist, for allowing me full use of their facilities. 32 DENTAL CLINIC Mr. G.P.L. Taylor submits the following report on the work of the School Dental Services:- Again there have been only two full time dental surgeons employed, but, as I had hoped, we have had more help from part time surgeons. This has resulted in the staff being able to inspect at school over twice the number of pupils that were seen during 1961. This means that some children are now inspected twice a year, thus reducing the number of casual and emergency inspections. I am glad to say we have also been able to increase the number of fillings in permanent teeth by over 2,000 We have hopes, this year, of recruiting some full time surgeons, so that we can look forward to offering a more stabil ized service to the public. 33 STATISTICAL SUMMARY SCHOOL POPULATION No. of schools No. on roll (28.12.62) Secondary 17 8,459 Junior 19 4,680 Infant 20 2,736 Special 4 290 Nursery 1 82 PERCENTAGE ATTENDANCE Jan. Feb. Mar. Apr. May. Jun. Jul. Sep. Oct. Nov. Dec. Secondary 91.1 91.1 89.8 89.1 93.5 90.0 87.2 94.2 94.4 93.1 88.2 Junior 90.3 89.8 90.0 88.9 92.4 89.9 87.5 93.6 94.4 91.8 84.7 Infant 84.6 82.9 85.0 84.0 90.0 90.8 83.4 90.9 90.8 85.2 77.1 Special 81.8 83.9 85.8 87.6 87.7 86.0 83.3 86.2 87.3 85.9 69.9 Nursery 80.3 72.1 77.0 91.3 86.6 80.4 76.3 88.8 83.1 81.7 68.9 Totals 89.5 89.0 88.8 88.1 92.4 90.5 86.4 93.2 93.6 91.2 84.9 MEDICAL INSPECTION Periodic Medical Inspections 5 years age group 1,211 10–12 year age group 1,497 14 years age group 2,258 Others 316 Total 5,282 Other Inspections Special Inspections 1,161 Re inspections 1,333 Total 2,494 34 (i) Individual Children found to require treatment- Age Groups Inspected (by year of birth) For defective vision (excluding squint) For any of the other conditions recorded Total 1958 and later 3 10 11 1957 13 133 135 1956 26 122 135 1955 12 32 43 1954 8 20 20 1953 9 13 14 1952 82 129 192 1951 58 96 134 1950 25 26 42 1949 11 12 19 1948 9 9 15 1947 and earlier 429 217 581 Totals 685 819 1,341 (ii) Physical condition of children inspected Age Groups Inspected (by year of birth) No.of pupils inspected No.whose condition Satisfactory was classified Unsatisfactory 1958 and later 63 63 – 1957 523 523 – 1956 583 583 – 1955 138 138 – 1954 55 55 – 1953 39 39 – 1952 795 795 – 1951 565 565 – 1950 145 145 – 1949 69 69 – 1948 49 49 – 1947 and earlier 2,258 2,256 2 Totals 5,282 5,280 2 (iii) Defects found at medical inspections - PERCENTAGE OF DEFECTS TO NUMBERS EXAMINED:- 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 Skin 2.2 3.1 3.9 1.9 3.1 6.1 4.7 4.6 3.8 4.2 3.3 Vision and Squint 8.9 9.0 10.0 11.9 15.2 14.1 15.7 17.1 11.1 14.8 15.0 Other eye 1.1 1.2 0.6 0.7 1.4 1.1 1.1 1.1 1.0 0.8 0.6 E.N, T. 6.2 6.4 5.4 3.3 5.9 6.7 4.7 4.1 3.6 2.4 3.4 Orthopaedic 7.8 4.0 4.1 3.9 4.1 4.9 5.0 6.4 3.1 2.9 2.2 Heart 0.5 0.4 0.3 0.3 0.4 0.3 0.2 0.3 0.3 0.3 0.4 Bronchitis etc 1.9 1.2 0.7 0.5 1.0 2.2 1.9 1.3 1.1 1.0 1.1 Other defects 4.8 5.7 3.3 3.8 5.3 5.1 4.4 5.1 4.4 3.6 3.6 35  PERIODIC INSPECTIONS Special Inspections Entrants Leavers Others Totals Treatm't Obs: Treatm't Obs: Treatm't Obs: Treatm't Obs. Treatm't Obs: Skin 33 18 69 74 74 25 176 117 16 36 Eyes - (a) Vision 42 47 429 77 214 73 685 197 17 9 (b) Squint 47 18 15 10 47 15 109 43 2 2 (c) Other 12 8 5 7 15 23 32 38 3 4 Ears - (a) Hearing 8 46 6 27 25 44 39 117 13 4 (b) Otitis Media 6 39 - 21 – 22 6 82 1 – (c) Other 6 3 14 7 17 3 37 13 8 6 Nose and Throat 43 112 26 48 31 76 100 236 17 5 Speech 22 45 4 10 21 32 47 87 10 11 Lymphatic Glands 3 70 1 13 1 32 5 115 – – Heart 5 46 9 33 5 54 19 133 4 1 Lungs 33 33 5 17 18 37 56 87 8 2 Developmental - (a) Hernia 1 2 – 5 – 4 1 11 3 – (b) Other 13 103 28 77 22 144 63 324 13 8 Orthopaedic - (a) Posture 1 25 14 96 15 124 30 245 6 – (b) Feet 14 25 2 26 20 47 36 98 3 – (c) Other 13 27 18 64 18 38 49 129 12 12 Nervous System (a) Epilepsy 6 2 3 1 7 2 16 5 – – (b) Other 1 5 11 6 8 25 20 36 3 3 Psychological (a) Development 11 39 – 7 10 32 21 78 13 12 (b) Stability 4 71 1 13 7 56 12 140 16 9 Abdomen 2 10 – – 2 15 4 25 – 2 Other – 2 1 – – – 1 2 15 8 36 (iv) Pupils found to have undergone tonsillectomy - Age Group Number Inspected Number found to have undergone tonsillectomy Boys Girls Boys Girls 5 years 590 621 54 36 10-12 years 713 784 114 134 14 years 1,008 1,250 181 203 Other 159 157 22 24 Totals 2,470 2,812 371 397 (v) Pupils found to have defects of colour vision Intermediate inspections Leaver inspections Others Tested for colour vision 1,497 2,258 64 Found to have defect of colour vision – 24 – (vi) Vaccinal condition of children inspected - No. inspected Prophylaxis S.P. Diph: Wh.C. Polio B.C G. No. % No. % No. % No. % No. % 5 years Boys 590 437 74.1 534 90.4 467 79.0 502 84.9 38 6.4 Girls 621 456 73.4 551 88.7 492 79.2 532 85.7 44 7.1 10 12 years Boys 713 359 50.4 603 84.6 363 50.9 518 72.7 32 4.5 Girls 784 417 53.2 689 87.9 443 56.5 546 69.5 29 3.7 14 years Boys 1008 527 52.3 894 88.7 348 34,5 694 68.8 364 36.1 Girls 1250 735 58.8 1220 97.6 461 36.9 998 79.8 628 50.2 Others Boys 159 88 55.3 148 93.1 112 70.4 140 88.0 13 8.2 Girls 157 88 56.1 129 82.1 91 57.9 119 75.8 13 8.3 (vii) Parents present at medical inspections Number inspected Number of parents present Per Cent 5 years Boys 590 561 95.1 Girls 621 592 95.3 10 12 years Boys 713 627 87.9 Girls 784 653 83.3 14 years Boys 1008 319 31.6 Girls 1250 447 35.7 Others Boys 159 135 84.9 Girls 157 118 75.1 37 (viii) Employment of Children No. of children examined 245 (ix) Employment of Children in Public Entertainment 2 (x) Examinations in School by School Nurses - (a) Uncleanliness - No. examined 12,336 No, found unclean 78 (b) Vision - No. tested 7,351 No referred for treatment 315 (c) Feet - No examined 5,078 No. referred for treatment 148 TREATMENT (i) CHIROPODY 1962 161 New Cases 482 550 Attendances 2286 2660 (ii) MINOR AILMENTS New Cases Re-attendances Boys Girls Boys Girls Ringworm Head - 1 - 20 Body - - - - Scabies - - - - Impetigo - 3 1 1 Other skin diseases 52 48 231 173 Defective vision and squint 20 23 5 2 Other eye disease 3 9 4 6 Ear, Nose and Throat conditions 42 32 86 63 Speech 20 9 10 3 Lymphatic Glands - - 2 - Heart and circulation 3 3 5 8 Respiratory diseases 9 6 16 8 Developmental defects 19 15 126 134 Postural defects 4 4 16 17 Plat foot 4 3 12 9 Other orthopaedic conditions 19 22 35 30 Nervous disorders 6 13 21 19 Psychological disorders 34 26 34 28 Various 42 52 55 55 Totals 277 269 659 596 38 (iii) DENTAL INSPECTION AND TREATMENT - Number of pupils inspected - Periodic age groups 13,279 Specials 704 Pound to require treatment 7,850 Number actually treated 3,165 Number offered treatment 7,501 Attendances for treatment 10,738 Half days devoted to inspection 103 - do - treatment 2,087 Fillings - Permanent teeth 8,059 - Temporary teeth 2,438 Teeth filled - Permanent teeth 6,542 Temporary teeth 1,863 Extractions - Permanent teeth 725 Temporary teeth 1,916 Anaesthetics - General 1,391 522 Pupils supplied with artificial dentures 43 Other operations - Permanent teeth 2,081 1,068 Xray examinations 282 Orthodontic treatment Orthodontic Surgeon Dental Officers Cases commenced during year 114 23 Cases brought forward 210 212 Cases completed 103 23 Cases discontinued 19 2 Removable appliances fitted 88 7 Fixed appliances fitted 2 – Number of sessions 138 24 Total attendances 1080 201 Cases seen in consultation with Dental Officers 122 39 (iv) SPECIALIST CLINICS (a) Eye CIinic New Cases Under 7 yrs. 7–11 yrs. Over 11 yrs. Total Boys Girls Boys Girls Boys Girls Boys Girls Hypermetropia 5 8 13 11 7 7 25 26 Astigmatism 12 13 28 19 13 6 53 38 Myopia 1 5 29 25 52 48 82 78 Other eye defects 32 30 25 15 20 23 77 68 Totals 50 56 95 70 92 84 237 210 Total attendances 3127 Glasses obtained (a) through the Hospital Service Optician 724 (b) through outside opticians 106 (b) Orthoptic Clinic - New cases 93 Total attendance 833 (c) Ear, Nose and Throat Clinic - New Cases Boys Girls Enlarged tonsils 13 13 Cervical adenitis 2 4 Nasal obstruction 7 5 Allergic rhinitis – 2 Repeated U.R.I. 5 2 External otitis 4 1 Wax – 1 Epistaxis 3 2 Otalgia 1 – Foreign body in ear 1 – V.MR. 6 1 Otitis media – 2 Short frenum 1 – Congenital deafness 1 – No defect 2 1 Hearing loss due to:- Old otitis media 9 6 Distorted drums 1 – Eustacbian 6 1 Conductive loss 1 2 Old mastoid 1 – Wax 2 Cervical adenitis 1 – Rhinitis 1 Nasal obstruction 1 1 Recurrent tonsillitis 1 1 Otorrhoea – 1 Trauma 1 – Nerve deafness 1 1 Kernicterus 1 – Mumps 1 – Cause unknown 1 2 Minimal loss 2 – Totals 74 52 40 Attendances - New cases 126 Old cases 290 Total 416 Cases referred to Hospital- Tonsils and Adenoids 38 Xray 9 Antrum washout 2 Cautery 1 Other 4 No. of sessions 44 (d) Orthopaedic Clinic - Boys Girls 5-16 yrs. Under 5 yrs 16-18 yrs. 5-16 yrs. Under 5 yrs 16-18 yrs. Anterior poliomyelitis 10 - - 9 - 1 Surgical tuberculosis - - - 1 - - Scoliosis, Lordosis, Kyphosis 74 1 - 81 1 - Genu Valgum 1 3 - 6 4 - Genu Varum 1 - - - 4 - Pes Valgus and Valgus ankles 41 3 - 34 7 - Cerebral palsy 8 1 - 13 1 - Schlatters Disease 1 - - 1 - - Progressive muscular atrophy 4 - - 2 - Osteo genesis imperfecta 1 - - 1 - - Talipes (a) Equino varus 7 - - 2 - - (b) pes cavus .. - - - 2 - - (c) Metatarsus varus - 4 - 1 3 - Torticollis 1 1 - 3 - - Congenital dislocation of hip 1 3 - 3 4 - Hallux rigidus 1 - - 1 - - Spina bifida 1 - - 1 - - Hallux valgus - - - 4 - - Perthes disease 2 - - 1 - - Overlapping toes 1 3 - 1 - - Hammer toes 4 - - 1 - - Claw toes 2 - - 2 - - Arthrogryposis multiplex Congenitae 3 - - - Transverse mvelitis - - - 1 - - Taut hamstrings tendo achilles 8 - - 7 - - Post meningitis paralysis 2 - - - - - Rotation of tibiae 2 2 - 3 2 - Other congenital defects 6 4 1 4 2 1 Miscellaneous (including chest conditions) 62 5 - 53 6 - Totals 244 30 1 238 34 2 New cases seen by Surgeon - School age 103 Under School age 32 Total 135 No. of cases seen by Surgeon From Physically Defective School 39 From other schools 337 Under school age 43 Total 419 41 Total number of examinations made by surgeon 554 Total number of cases discharged by surgeon 98 Average number of examinations per session 42.6 Number of treatments given 8030 Number of attendances for after care 1317 Number of sessions held - treatment 447 inspection 13 Number of visits by instrument maker 45 Operations performed 21 Children transferred from Connaught Hospital 6 Total number of treatments 9415 Attendances for ultra violet light treatment 78 (e) Child Guidance Centre Tables I and II Analysis of Problems Referred and Cases Diagnosed (WALTHAMSTOW CASES ONLY) Referred Diagnosed 1. Nervous disorders e.g. fears, depressions, apathy, excitability 37 33 2. Habit disorders and physical symptoms e.g. enuresis, speech disorders, sleep disturbances, tics, fits, etc. 16 5 3. Behaviour disorders, e.g. unmanageable, lying, tempers, stealing sex problems, etc 60 15 4. Educational e.g. backwardness, failure to concentrate 2 5 5. No basic disturbance of child, i.e. mainly parental overanxiety 12 Table III - Analysis of Cases Closed during 1961 1. Improved and recovered after treatment 32 2. Improved after partial service, i.e. before diagnosis – 3. Diagnosis and advice only 12 4. Interrupted, e.g. on parents' or adolescent patient's initiative 40 42 5. Closed for miscellaneous causes (removal from area, placement at E.S.N, school, etc.) 16 6. Spontaneous improvement 1 (f) Paediatric Clinic - New Cases Over 5 yrs. Under 5 yrs. Boys Girls Boys Girls Heart 7 8 3 - Pulmonary stenosis - 1 - - Vomiting - - 1 - Jaundice - - 1 - Coelic disease - 1 - - Hernia - - 1 - Hydrocele 3 - 1 - Varicocele 1 - - - Undescended testes 23 - - - Tight foreskin - - 1 - Enuresis 7 3 1 - Psychological 1 - - - Retarded development 1 1 1 1 Speech - - 1 - Cerebellar malfunction 1 - - - Epilepsy - 1 - - Migraine 1 1 - - Asthma 1 - - - U.R.I. - 1 - - Haemoptysis - - - 1 Torticollis - - 1 - Epistaxis 1 - - - Obesity 3 1 - - Totals 55 18 12 2 Total attendances 208 No. of sessions 21 Referred to Hospital 21 43 (V) SPEECH THERAPY High St. Clinic Wingfield House Clinic Number in attendance at beginning of year 79 60 Number under observation at beginning of year 34 27 New cases 43 63 Re-admitted 1 2 Transfers from other clinics - Within County 1 2 Cases discharged - cured 36 56 improved 2 2 defaulted 2 2 transferred to other clinics 4 4 left district 2 - left school 2 - Cases in attendance at end of year 61 50 Cases under observation at end of year 48 40 Total attendances during year 1754 2145 Analysis of Defects Stammering and cluttering 41 17 Dyslalia 110 65 Stammering and dyslalia - 8 Delayed language development 2 34 Cleft palate speech - - Voice defects - 8 Speech defect due to deafness 1 - Defects of neurological origin 2 12 (vi) CONVALESCENT HOME TREATMENT - Number of children sent away for convalescent holidays 19 (Vii) TUBERCULOSIS - Boys Girls No. examined for the first time at the Chest Clinic: - Referred by School Medical Officers 14 10 Referred by private practitioners 34 26 Examined as contacts 5 8 44 IMMUNISATION (a) Diphtheria - Primary immunisations (children of school age) 57 Booster doses ( do. ) 347 (b) Whooping Cough - No. of school children immunised 23 (c) Tetanus - No. of school children immunised 71 (d) B.C.G.- 1962 1961 No. invited 1862 2462 No. accepted 1196 1586 Acceptance rate 64.2 64.4 Number of Heaf positive 205 220 Percentage positive 18.0 14.5 Number of Heaf negative 931 1291 Number absent 60 75 B.C.G. given 931 1291 Conversion tests - positive 499 761 negative 3 INFECTIOUS DISEASES Notifications years 1962 1961 Measles 28 625 Whooping Cough 8 14 Scarlet Fever 49 82 Pneumonia 2 1 Dysentery - 20 Tuberculosis 4 3 Food Poisoning 2 1 Poliomyelitis - - Diphtheria - - Meningitis - 1 SCHOOL MEALS SERVICE Inspections by Public Health Inspectors - Schools 32 Kitchens 69 No. of milk samples taken (all satisfactory) 11 45 NATIONAL SOCIETY FOR THE PREVENTION OF CRUELTY TO CHILDREN Nature of Offence How dealt with Neglect 22 Warned 44 Ill-treatment 6 In Juvenile Court 1 Beyond control 1 Prosecuted 1 Unregistered foster-child 1 Advice sought 16 No. of children dealt with Boys 69, Girls 56 (17 under 5 years of age). HANDICAPPED PUPILS No. of pupils ascertained during 1962 No. of pupils admitted to Special Schools during year Total No. of pupils in Special Schools at end of year Day Resid. Day Resid. Blind - - - - 3 Partially Sighted - 1 - 7 - Deaf - - - 1 1 Partially Deaf 1 - - 5 - Educationally Sub-normal 19 20 - 95 1 Epileptic - - - 1 3 Maladjusted 6 - 5 - 19 Physically Handicapped 3 3 - 17 7 Speech - - - - - Delicate 12 10 - 24 2 Dual Defects* - - - 3 2 Totals 41 34 5 153 38 *Children having more than one defect:- Attending Day Special Schools - 1 ESN/Maladjusted 1 Hemiplegia/Epilepsy 1 Enuresis/Maladjusted Attending Residential Special Schools - 1 ESN/Hypoglycasmia/Poor Vision 1 ESN/Epilepsy 46 CHILDREN ATTENDING THE SPECIAL SCHOOLS Partially Sighted Deaf Open Air School Educational ly Subnormal Walthamstow 7 6 42 94 Forest 6 15 25 1 South Essex 7 1 - - Barking 3 4 - - Dagenham 10 2 - - Ilford 2 9 - 1 Leyton 2 10 19 - Romford 3 8 - - Middlesex 6 - 1 - S.E. Essex 3 1 1 - Hornchurch - - 1 - Hainault - - 1 • WALTHAMSTOW CHILDREN IN RESIDENTIAL SCHOOLS Blind 3 Epileptic 3 Deaf 1 Maladjusted 19 Delicate 2 Physically Handicapped 7* Educationally Subnormal 3 * In addition there is one physically handicapped child having home tuition. MISCELLANEOUS Staff Medical Examinations - County Council Staff 153 Other Staff 279 Prospective Teachers and Entrants to Teaching Profession 118 47 Comparison of heights and weights of London and Walthamstow school children Median (50th percentile) Age Height (ins) Weight (lbs) Boys Girls Boys Girls L.C.C. Walth. L.C.C. Walth. L.C.C. Walth. L.C.C. Walth. 554 43.7 44.0 43.4 43.6 43.1 43.7 42.2 42.5 6½ 46.0 46.5 46.0 46.1 48.6 49.1 48.1 48.0 7½ 48.5 48.9 48.1 48.6 53.5 55.1 52.1 53.8 8½ 50.8 51.0 50.3 50.6 59.8 60.6 58.5 59.2 9½ 52.9 52.9 52.5 52.6 66.0 66.2 64.9 65.1 10½ 54.7 54.9 54.7 54.8 72.3 72.5 71.9 73.0 11½ 57.0 57.1 57.6 57.5 80.3 81.0 82.1 83.2 12½ 58.7 59.7 59.8 60.2 88.4 91.6 93.4 95.0 Average difference 0.3 0.2 1.0 0.8 10th percent ile Age Height (ins) Weight (lbs) Boys Girls Boys Girls L.C.C. Walth. L.C.C. Walth L.C.C Walth L.C.C. Walth 5½ 40.7 42.4 40.9 41.0 36.8 38.0 35.8 36.0 6½ 43.3 43.7 42.7 43.3 39.0 42.5 38.2 40.3 7½ 45.6 46.0 45.4 45.7 45.5 47.0 43.4 44.6 8½ 47.7 48.0 47.4 47.6 49.0 50.2 47.5 49.1 9½ 49.6 49.8 49.3 49.4 55.2 55.2 53.6 53.9 10½ 51.5 51.6 51.4 51.3 58.5 60.2 57.5 58.7 11½ 53.4 53.6 53.4 53.7 65.6 66.9 65.0 64.9 12½ 55.2 55.9 55.7 56.3 72.5 76.0 73.4 74.2 Average difference 0.5 0.3 1.7 0.9 90th percentile Age Height (ins) Weight (lbs) Boys Girls Boys Girls L.C.C. Walth. L.C.C. Walth. L.C.C. Walth. L.C.C. Walth. 5½ 46.7 46.6 46.5 46.2 52.9 51.8 52.0 49.7 6½ 49.1 49.3 49.0 48.9 59.0 58.7 59.3 57.7 7½ 51.4 51.8 51.1 51.5 65.1 66.2 65.7 66.3 8½ 54.1 54.0 53.4 53.6 74.7 74.2 73.7 75.3 9½ 56.4 56.0 56.1 55.8 81.0 82.7 83.4 84.5 10½ 58.4 58.2 58.4 58.3 90.6 92.2 96.1 95.6 11½ 60.8 60.6 61.6 61.3 105.2 104.3 110.9 109.5 12½ 62.7 63.5 63.6 64.1 114.7 119.2 122.9 125.3 Average difference 0.1 0.0 0.8 0.0 Note: L.C.C. figures are calculated from measured values for 1959 Walthamstow figures are taken from smooth curves fitting calculated values for 1960 .