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03
Tubercle. Paralysis. Heart disease.
Various
Age of onset. Other Pseudo- deformities. Other
Hip. Spine. Knee. Various. Infantile. Spastic. forms of hypertrophic Congenital, forms.
paralysis. and muscular dystrophy..
_
Not ascertain- 59 42 36 23 151 2 3 3 74 — 111
able
Birth 1 5 — — 9 157 12 1 253 216
Under 1 8 8 3 5 161 21 3 1 86 — 2
1 24 33 18 6 221 9 1 2 110 — 10
2 44 56 33 14 146 9 2 2 41 — 16
3 73 76 28 12 117 7 — 2 42 — 31
4 71 54 25 13 59 2 — — 32 — 56
•5 75 47 30 14 42 1 — 2 32 — 80
6 60 26 27 11 15 — — — 21 — 74
7 39 10 21 13 9 — — — 22 — 88
8 28 6 16 13 5 — — 1 17 — 77
9 13 5 10 3 2 — 1 — 23 — 69
10 11 2 2 4 4 — — — 6 — 44
11 3 2 4 2 2 2 — — 8 — 30
12 — — 1 3 — — — — 2 —17
509 372 254 136 943 210 22 14 769 216 706
4
From the foregoing it would be evident that heart disease becomes manifest during the period
of school life chiefly between the ages of 4 and 10. In 468 cases (201 boys and 267 girls) the heart
disease followed rheumatism and in 101 cases (31 boys and 70 girls) chorea. It may be added that
the incidence is greater in the female sex. The lesion was mitral regurgitation 481 cases, mitral stenosis
38. double mitral 106. aortic 13. and aortic and mitral 54.
Heart
disease
There are a number of cases of heart disease in the ordinary schools whose condition is not such
as to require special school education and in which the conditions remain stationary or become ameliorated
The P.D. schools contain the more severe cases and in many instances these show a progressive advancement
starting as a mitral regurgitation and later showing signs of stenosis or an involvement of the
aortic valves ; in many of these the outlook is unsatisfactory, the greater number of children who have
to be invalided from special schools belong to this class. They also give rise to difficulties of subsequent
employment and after care.
The question of handicraft instruction raises problems concerned not only with the present
condition, but with the future employability of the subject. It has been considered in this report chiefly
from the standpoint of the pupil ultimately following a trade for which such handicraft instruction
directly prepares.
Occupations for boys.—Artistic trades : In considering possible occupations, there would seem
to be relatively less difficulty in arranging for those boys who show any clerical or artistic ability, but
difficulties arise in connection with those who are mentally less well-equipped. Probably it would
prove profitable to consider at an early stage the development of the artistic aptitude. Those children
who are capable of some accuracy might prove themselves very suited for such trades as ticket-writing,
sign-writing, and mechanical or architectural drawing; those who combined accuracy with some artistic
ability might be well fitted for various forms of art designing; while those who could combine these
with adequate manual dexterity would be well suited for light metal work and the various branches
of the jewellery trade, watch-making, piano stringing, or light leather work.
Clerical work : The clerical occupations are very suitable for most varieties of physically defective
children whose upper limbs are comparatively unaffected. They provide to a large extent the rest
required for some of the less serious heart cases and many affections of the lower limbs and deformities
in general which do not interfere with writing. Shorthand would be a valuable asset; when typewriting
is included the work is of a somewhat more strenuous character than some artistic occupations
above mentioned.
Woodwork : Woodwork, save in the lighter branches of carving and cabinet-making, is probably
too heavy for physically-defective children, and they are unlikely to be able to compete successfully
with their more favoured fellows, unless possessed of special aptitude.
Tailoring: Probably few physically-defective children will be capable of becoming all-round
tailors owing to the weight of the irons and machines, unless power is available to work the machines.
This will probably exclude a large part of the provincial trade, but in London the industry is very subdivided,
and it is possible for specialised parts of the work to be undertaken which are of a much lighter
character—e.g., button-holing, waistcoat and trouser-making—where the pressing is undertaken by a
separate individual. Economically, however, these are the less advantageous branches of the trade.
Bootmaking : Bootmaking is suitable for those whose mentality is unequal to the more skilled
trades, but again, few would be able to undertake the whole process, some branches of which are heavier
than others. The sewing of the uppers might suit a certain number, but general repair work is
probably too heavy.
Leather trades: The leather trades are suitable for those who have good stamina, and are
physically fit, save for some arrested lesion which does not impede the movements required; these
trades have been found very successful for those who have had a lower limb amputated, whether for
accident or disease.
Handicraft
instruction
in schools
for
physically-
defective
children