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(b) Reports from hospitals or domiciliary midwives, on the discharge of mothers
from their care, which may indicate "at risk" factors or any abnormalities.
(c) Information given by doctors and health visitors who see almost all young children
either in welfare centres or in their own homes.
Children "at risk" are kept under special surveillance and are medically examined
regularly in order to assess their developmental progress; these examinations include also
"screening" tests for vision and hearing. If any abnormality is suspected, the child may
then be kept under close supervision or may be referred for further examination by a paediatrician,
otologist or ophthalmologist. When a handicap such as defective vision or hearing
or mental retardation is diagnosed, the child's name is then entered in the handicap section
of the register but, as congenital defects are often multiple, the child remains under surveillance
as being "at risk" until it is reasonably certain that there is no other abnormality.
The purpose of the register is therefore twofold - the early detection of handicapping
conditions, and to ensure that cases are kept under review and action is initiated
to remedy or ameliorate the conditions found. This results in treatment and training being
given to the child at a time when it is most beneficial. Support and advice is given to the
family as a whole and long-term provision is made for the child's future education and
training if it seems unlikely that he will attend a normal school.
As soon as the examining doctors are satisfied that the child sees, hears and communicates
normally, and that there is no other handicap, its name is removed from the list
of those "at risk".
Total number of children under five years
of age on the Handicap and Observation
Register at 31st December, 1965 945
Number of handicapped children under
five years of age included above 161

NOTIFICATION OF CONGENITAL MALFORMATIONS
Since 1st January, 1964, all congenital defects apparent at birth have been
notified to the Registrar General from information given by doctors and midwives on Notifications
of Birth.
During the year, sixty-four children (including two stillbirths) were notified as
showing such defects. Of these, three showed more than one defect and in two there were
multiple abnormalities and gross defects.
CONGENITAL DEFECTS NOTIFIED IN 1965
Central Nervous System:
Anencephalus 1
Hydrocephalus 1
Spina Bifida 4