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selected few of the great group of semi-blind, semi-deaf, nervous and debilitated, which exists in the
elementary schools. Their admission to P.D. schools would be unnecessary if simpler schools existed.
With the enormous amount of child material handled in the London schools there are greater opportunities
of selection and classification than exist anywhere else, and there should be corresponding provision,
as suggested at p. 48 of last year's Report.
Ability of P.D. Children to Earn their own Living. An effort was made to
estimate how many of these children would be able to earn their own living or to contribute to their
own support. The proportion with each class of disease had to be considered, the probability of their
growing up, and the chances of escaping without considerable deformity or delicacy to impair their
powers; educational backwardness, the poor mental capacity of many of the children, and the long
period of apprenticeship probably necessary for any skilled work were, however, left out of reckoning.
The general conclusions arrived at were :—
Able to work at ordinary occupations and probably to earn their living 20%
Able to work at special occupations if taught, to contribute to their own
support, and possible in some cases to earn their living 50%
Not likely to live, or likely to be so severely crippled as to be incapable of
work 30%
With co-operation of teachers and managers an attempt was made to find how past experience
would tally with this estimate. The children who could be traced were mostly traced by after-care
committees, and many were still learning and earning very little, many were lost sight of, and others
who would come into the first two classes had gone to ordinary schools. The enquiry seemed to indicate
that the above theoretical estimate was too optimistic, and that a larger proportion than 30 per cent.
drops out or fails to make a livelihood.
Considering the conditions seriatim of the children with tuberculous disease, a certain proportion
die of the disease, or other tubercular infection, meningitis, etc. Some others become so crippled or
delicate as to be useless as workers. These account for 15 to 20 per cent. Of those who will subsequently
be able to work, most are cured of the actual disease during the school years. They are often
transferred to the ordinary schools, and in any case should be able at 14 or 16 to commence attendance
at technical schools. This applies also to other deformities or paralyses. Those incapable of getting
to such schools should be provided for in homes where possibly they could contribute something by
work to their own support. The heart cases in these schools mostly die before adult life. Nearly half
the deaths among P.D. pupils are from heart disease, and it is even more fatal in the years immediately
succeeding school life. They miss the regular surveillance of school, and are often put to work that
breaks down the balance of their heart compensation. Such children in these classes as are to be expected
to earn their own living should be capable of attending technical centres or undergoing apprenticeship
in trades which are suitable to their condition.
VISION,
Routine vision testing is regularly carried out in all the elementary schools as well as in the
secondary schools and training colleges. The ordinary school examinations are necessarily
superficial, and beyond the school comparatively little use is yet made of the knowledge of existing
defects thus brought to light. The affected children are followed up in school each year, and the
teachers show increased appreciation of the help which these examinations give them, as indeed
they do of nearly all the medical inspections carried out in the schools.
The provision of treatment, particularly by spectacles, is still unsatisfactory. The Voluntary
Association for providing spectacles for school children has done much good, although the demand on
its resources in the way of organised service has been very great and at times the supply of
glasses slow. This Association has, however, practically brought glasses within the reach of all by
reducing the unreasonably high prices hitherto charged. Attention being drawn to these prices
many of the hospitals have made arrangements for their patients to obtain spectacles at prices
which they can afford, and which this Association was the means of first obtaining for the school
children.

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