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Alavac (Alum precipitated extracts) was tried in
one patient with excellent success and is
probably treatment of choice as it involves a
significantly lower number of injections (7-8),
compared with the standard aqueous
pollenvaccines, which were given to the other
5 children (18 injections). Three children did very
well during the summer, one moderately and one
child had his treatment interrupted as he was
selected for six weeks' convalescence in
Switzerland aided by a voluntary scheme
operating in the Borough.
Three children during 1966 were referred to a
day open air school owing to the severity of their
asthma and considerable loss of schooling. All
these children were of primary school age where
placement away from home might have been
added traumatic experience.
Much emphasis is attached to adequate
counselling of school leavers as the prognosis
and possibly life expectancy might well depend on
suitable employment. The importance of an
optimum education is emphasised to both the
children and their parents, as loss of schooling
can superimpose the disadvantages of a poor
education onto a young person whose clinical
condition already might restrict his choice of a
suitable occupation.'
Hearing clinic
The work at the clinic continued to expand during
the year and plans were approved for an extension
to the present unit.
The staff continued to work as members of a
medical/educational team. In addition to the
routine work in the clinic, the schools and the
children's homes, other activities such as the
organisation of parents' meetings have continued.
A three day course for training local authority
medical officers was held in October and
representatives from many of the Greater London
boroughs came to see something of the work of
the clinic and to learn about the methods used
for the detection of hearing loss in young
children, and the assessment of hearing loss in
deaf children.
The number of new cases seen at the clinic
during the year was 316. This is an increase on the
previous year and the cases tend to be more
complex. Medical officers are now becoming more
aware of the problems of children with speech
defects, or children who are backward with their
speech development and nearly all these cases are
now referred for screening for hearing loss.
Similarly all children with any other type of
handicap are now seen routinely. Eighty one
children at the Isleworth Junior Training School
were screened during the year for a hearing loss.
Nineteen children were found to have a hearing
loss not requiring consultant opinion and a
further sixteen children were referred to Dr Fisch
either for a hearing loss or because they could
not be tested at the training school. Of these, six
were found to have a significant hearing loss and
three were issued with hearing aids. 544 cases
were re-examined at the clinic during the year
either by Dr Fisch, the consultant, or the
principal medical officer.
Routine audiometry was undertaken in schools
as in previous years and children who failed
sweep tests were re-tested at the local clinic and
then referred to the school medical officer if this
was thought necessary.

The work with hearing aids has expanded and
during the year audiometricians took 358
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