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4. The facts as set out do not in any way conflict with acceptance of a flea hypothesis of
spread of scarlet fever, provided it is borne in mind that there is undoubted evidence to show
that in the poorer areas the disease tends to attack children at a younger age than in well-to-do
areas and thus renders the poorer children at the higher ages immune from attack.
Admission
examinations.
Defective Children.
The total number of examinations conducted under the special Acts during the year was 4,264,
as compared with 5,566 for 1917. Of these 993 were deemed suitable to attend elementary schools, 126
a blind school, 191 a school for myopes, 996 P.D. school, 1,386 M.D. school, 8 open air school, 59 hard of
hearing school, 88 a deaf school, 32 were epileptic, 254 invalided from school attendance, 99 imbeciles,
13 feeble minded ineducable, 19 idiots.

Rotn visits
The special schools were visited at least once a quarter, and every child present was seen at least
once during the year. During these visits the scholars were re-classified—158 were transferred to
elementary schools, 8 to deaf schools, 8 to blind and myope schools, 17 from physically defective to
mentally defective schools, 6 from mentally defective to physically defective schools, 27 were excluded
from mentally defective schools as imbecile, 35 were invalided on medical grounds and 2 over 14
years of age were excluded as no longer certifiable. In addition 1,555 special examinations were
made of children already on the rolls of special schools in connection with applications for non-enforcement
of attendance at special schools, committals to industrial schools, reformatories, etc.

In the age groups, out of a total of 129,202 examined, the following were found to be the mental
conditions of the children: Dull or backward, age group 8-9 years, boys, 5.5 percent., and girls, 4.7 per
cent.; leavers, boys, 6.7 per cent., girls, 6.8 per cent.; mentally defective, age group 8-9 years, boys
and girls 0.43 per cent.; leavers, boys and girls, .015 per cent.
Mental Deficiency
Act
Attendance
at Myope
Schools.
During the year there were referred by the local education authority to the local authority under
the Mental Deficiency Act, 205 cases, of which 77 were feeble-minded, 113 imbeciles, and 15 idiots.
Attention has been drawn to the fact that there was a great difficulty in persuading parents to
allow children who had been certified as suitable for a myope school to attend such school. In order
to overcome this difficulty a memorandum containing advice to parents of short-sighted children who
have been recommended for admission to a myope class was prepared, explaining the advantages
to bo derived chiefly from a medical point of view.
Residential
institutions.
There are 8 residential and industrial schools, 2 reformatories, 6 residential schools (2 for
blind, 3 for deaf, and 1 for mentally defective children), with a total accommodation for 2,097 residential
and 252 day scholars. To each institution is allocated a medical officer and a dentist, whose
duties have been set out in previous reports. During the year 900 boys were admitted to Harrow
Road Place of Detention, 1,495 boys to Pentonville Road Place of Detention, and 580 girls and infants
to Ponton Road.
Epileptics.
During the past three years a register has been kept of all children reported as epileptic, and a
large number of them have been specially medically examined. It is probable that this register forms
a fair estimate of the numbers of the school attending population affected. It does not, however, necessarily
contain the names of all children and the information is only to the date of the last examination
*Of the children admitted to P.D. schools, 28.5 per ccnt. were suffering from tuberculosis of bones and joints.
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