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V.—A.B., No. 9,615, boy, aged 12, January, 1908; Deaf School:—
Brother normal. Sister of 7, defective in similar way (No. 15,152 above).
Never spoke till admitted to centre 13 months ago ; since then has been taught lip-reading and made
considerable progress. Hearing defective, conversational tones at 12 feet, but understanding of words
is exceedingly defective compared to hearing. Defects in consonantal combinations—s, z, n, 1, being worst
—are much greater than in a " speech defect'' child in an ordinary school whose enunciation corresponds
to that of this boy.
When only allowed to hear, the capacity of reproduction was much reduced, lie has been classed
as congenital word deafness, but it is difficult to judge how far actual deafness and how far lack of
understanding account for the ultimate result. This boy is, 10 months later, at Anerley, doing well.
VI.—A.H., No. 10,197, girl, aged 12, January, 1908 ; Deaf School:—
Very little speech on admission ; considerable progress since then. More intelligent in studies than
most deaf children. Spoke a little (?) before attack of whooping cough at age of three. Spontaneous speech
intelligible, hearing greatly reduced ; watch on contact.
She clutches at whole words and either gets them completely or not at all. Guessing is very great.
Strangeness of a word enormously increases her difficulties ; she gets the " n " clearly in " pen," but fails
with it in 44 gun." Lip-reads perfectly, except for some difficult combinations, Nd, Fn, Dn, CI, Gn. With
sound only easily makes mistakes.
She is semi-deaf, a typical lip-reader, making mistakes in G and N, the most difficult consonants to
see, but some mistakes are those never made by a pure lip-reader, e.g., Fr for Thr, and Sk for Sp. She therefore
depends partly on hearing, or else on the memory of sounds heard before she became deaf.
Examined later at the Elementary School to which she was returned, it was found that the whole
trouble was semi-deafness or hardness of hearing, and that there was now no difficulty in understanding
all she could hear.
PHYSICALLY DEFECTIVE SCHOOLS.
The special schools for physically defective children are intended for the education of those children
who, owing to chronic disease or crippling deformity, are unable or unfit to mix with healthy children in
the ordinary schools. These children have often lost much schooling owing to prolonged illness, and require
to be rendered capable of earning their own living by means of some skilled trade, and it is often considered
advisable that they should remain at the special school up to the age of 16 even though their
disease is cured, provided that the instruction they obtain by so remaining is likely to enable them to
earn their own living. Children should not be sent to the P.D. centres simply because they are backward
owing to previous ill health, nor on account of malnutrition the result of poverty or want of care, although
the temptation on the doctor's part to procure some help for these cases that he knows will otherwise
drift downwards is always very great. As a result of his careful examination, Mr. Elmslie defines the
children who can be considered as proper subjects for these physically defective schools as :—
1. Those with tuberculous disease of the bones and joints, and most of these should be retained
in the centres even when the disease is quite or apparently cured, because it may relapse even after
several years' quiescence, or the deformity left may render it desirable to prepare the child for special
skilled work.
2. Paralysed children.
3. Children with various deformities of the trunk or limbs if
(a) the deformity is sufficient to render them unable to mix with healthy children.
(b) the deformity is increasing.
(c) they are under treatment requiring some observation, e.g., by the school nurse.
(d) if orthopædic instruments have been worn which are liable to injury.
4. Certain children with heart disease.
5. Children convalescent from or liable to recurring attacks of chorea.
6. Certain rare chronic cases, e.g., chronic rheumatism, asthma, chronic bronchitis, exophthalmic
goitre, haemophilia, and so on.
7. Exceptionally, certain children who are semi-blind or semi-deaf.
8. Cases admitted on probation, who have doubtful defects and illnesses of various kinds, and
including some whose mental status is indeterminate.
The children who should be considered as not suitable for admission are those with
1. Trivial deformities.
2. Deformity or paralysis accompanied by evident mental defect.
3. Rapidly increasing paralysis (pseudo-hypertrophic).
4. Hernia.
5. Epilepsy, except occasional cases with petit mal.
6. Lupus and other chronic skin diseases.
7. Children who are objectionable from offensive discharges or habits, or from dirt.
8. Nervous, delicate children and those said to suffer from fits, anaemia, adenoids, etc., but who
present no real evidence of disease.
0. Mentally defective children including cretins.
Physically Defective Children—There are now 20 Physically Defective Schools with 2,440
children on the roll. Three of these are held at hospitals (Royal National Orthopaedic Hospital, Alexandra
Hospital and the Home for Incurables, Hampstead), where chronic cases are treated. Mr. R. C. Elmslie,
who has been paying special attention to the physically defective children, has now completed the card
index of each child. An analysis of 1,050 cases was given in the last Report with a discussion of the