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purposes and also two speech therapy rooms. The
former speech therapy room has reverted to
school use.
Most of the handicaps in children who will
need special education are now detected early,
due largely to the use of the observation register
and the compulsory notification of congenital
defects. This has led to an expansion of the work
with pre-school children. The six monthly visits to
the unit for medical assessment by the doctor,
the weekly or fortnightly visits for physiotherapy
and/or speech therapy, and the general advice
given to parents have been of great value to the
pre-school child.
Group meetings for parents of pre-school
children have also been initiated with a gratifying
response. The first meeting was held in an
afternoon when parents were able to meet other
handicapped children and their brothers and
sisters. This was followed by two evening
meetings, one where methods of training spastic
children were discussed and the other where the
physiotherapists, speech therapists and nursing
sister spoke about their work with the pre-school
child and discussed the role of the parents.
Practical aids were also demonstrated on this
occasion.
The work of the four physiotherapists at the
unit was augmented by a student physiotherapist
from West Middlesex Hospital. Each half term
one student therapist received six weeks' training
at the unit and both the students and the staff
of the unit have found the arrangement valuable.
In the early part of the year the physiotherapists
were able to start training the children in school
sports, field events and archery. In the Summer
they organised the first school sports day and
subsequently entered some of the children for the
British Sports for the Disabled at Stoke
Mandeville Hospital. This proved a very
successful venture and a number of first and
second prizes were collected.
During the year half the children at the school
were receiving speech therapy. About one third of
these children had severe speech defects caused by
cerebral palsy, mainly spastic and athetoid
dysarthia and dysphasia. Other speech defects
treated included dysphasia, dyslalia, delayed
speech and language development and
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stammering. The new purpose-built rooms made
treatment more enjoyable for both child and
therapist.
Surgeons have been operating on children born
with spina bifida and meningomyelocoele for
some years now and the number of referrals for
this handicap to the Medical Advisory Unit and
in turn for admission to Martindale School, has
increased. The number of cerebral palsied
children seen at the unit also increased, whilst
incidence of other types of handicap remained
approximately the same.

Child Guidance Clinic
I am grateful to Dr P Calwell MB BS DPM for
submitting the following information—
'This year showed a considerable number of
changes in the clinic. Dr Levinson who had been
medical director from January 1962 resigned in
April 1966. During the four years he was medical
director there was a steady increase in the number
of cases referred to the clinic, and this trend
continues.
Dr Levinson, before he left, put forward
recommendations for an increase in staff, and a
number of these were approved by the appropriate
committees during the year.
I succeeded Dr Levinson first as locum and
subsequently as medical director. Miss J W
Robertson, psychiatric social worker, joined the
clinic staff on a full-time basis, replacing
Mrs Westland. We were also sorry to lose
Miss Haynes who had been with us longer than