View report page

60
would be entirely missed during school lite. Of the 56,571 special cases 33,637 were referred for treatment
or placed under continued observation for defects.
Secondary
school
children
8,878 children in secondary schools (exclusive of trade schools and training colleges) were inspected
during the year, including 5,672 girls and 3,206 boys; 1,808 were found to require treatment for dental
defect, or 20 per cent., which corresponds very closely with the percentage of leaver children in the
elementary schools so found.
1,442 pupils required treatment for visual defect, or 15.1 per cent., as compared with 12.8 per
cent. of leaver children in the elementary schools. 979, or 17.3 per cent. of the girls suffered from
defective vision, the excess of girls over boys being as marked here as in the elementary schools.
369 pupils suffered from defects of the nose and throat, or 41 per cent., which is in close approximation
to the proportion referred for treatment in leavers from the elementary schools. 86, or rather
less than 1 per cent., had defective hearing, as compared with 1.5 per cent. of leavers in elementary
schools and 32, or 0.37 per cent., suffered from ear discharge as compared with 2.9 per cent. of elementary
school leavers. 263, or 2.9 per cent., were found with anaemia compared with 4 per cent. of elementary
school leavers.
As the examinations in secondary schools have hitherto not been standardised as carefully as
those in elementary schools, and more variation is apparent in the results obtained by different school
doctors, it is impossible to feel the fullest confidence these figures. From the beginning of 1921 a
schedule based upon that issued by the Board of Education will be in use and a more reliable comparison
will be possible in future year3.
The figures given, however, show how necessary medical supervision of the health of pupils is
in every type of school, and specially noticeable is the strain which modern education throws upon the
eyes of all students.
Stammering children.
It was computed from the medical inspection returns that there would be about 1,200 stammering
children in the London schools, and that the boy stammerers would outnumber the girl stammerers
in at least the proportion of three to one. In preparation for the establishment of special classes the
teachers of all the schools were asked to forward the names of all the stammering children under their
care. They were also asked to estimate the degree of the infirmity under the headings acute, moderate,
and slight. The total number of notifications received was 914, 682 of boys and 232 of girls.
It was arranged that five classes should be formed of twenty children each. All were kept under
observation by the school medical officer. A considerable measure of success attended the work at
the classes. Out of 76 children, 34 were discharged cured at the end of the first term, and 32 others
who had shown improvement were recommended for further attendance. Considering that the first
term's work was experimental, and that many disturbing influences necessarily obtained at the
beginning, these results must be regarded as highly satisfactory.
The case of each child was carefully investigated from the medical point of view. There were
found to be two distinct sets of cases. In the first the stammering came on together with the development
of speech; these cases were the more difficult to cure. In the second, the stammering came
on later after a period during which the child spoke normally. Frights of various kinds were frequent
causes, and amongst these air raids during the war played a part. Night terrors and nightmare were
associated with many of these. The majority of the children were found at the outset to possess very
poor chest development with marked rigidity and spasmodic breathing. Part of the training was
accordingly directed towards the improvement of the condition of the chest, particularly with the
object of inducing relaxation.
In the case of a class held at Santley-street (Brixton), out of twelve children in whom the
stammering was first noticed at or before the sixth year of age, only three were cured by the end of the
course, whereas out of seven children in whom the stammering developed after the age of six, six
were cured. Of these seven children it is interesting to note that stammering in two was ascribed
to the effects of fright (one by air raid, the other by a dog), two were imitative cases, and in two the
condition was ascribed to rheumatic fever. The common association of rheumatic fever with another
disease of co-ordination in childhood (namely, chorea) is, of course, well established.
The most noticeable feature about the aspect of a class of stammerers at the beginning was the
strained and anxious look they collectively presented. It was amazing how this improved during
the course, as the children found more confidence in themselves and entertained solid hopes of cure.
It was considered by the medical officers that it was a disadvantage to have older boys and girls
together in the same class, as the children appeared to be more self-conscious in the presence of those
of the other sex, and an exaggerated self-consciousness is, of course, a special feature of the mental
state of the stammering child.
The classes were reorganised recently ; the elder boys and girls are instructed separately, and
each class consists of 12 children only. The total accommodation is now 144, and, if all the children in
attendance during each of the three terms could be cured, the output of the classes would be 432 a
year. Assuming, however, that each term 72 children (50 per cent.) will be receiving further treatment,
about 300 individual children will be dealt with annually. In a few years time therefore the
arrears will be overtaken. Younger children will be admitted in an increasing proportion, and the
attendance at the classes will slowly fall, owing to the difficulty of such children travelling alone.
The centres at which the classes are held will then tends to move outwards, towards the county
boundaries. This will afford the Council an opportunity, if desired, of co-operating with extrametropolitan
authorities in accordance with section 6 (1) of the Education Act, 1918, since the density
of population of stammering children in the areas of these authorities may be too small for local classes.