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formed, in 138 cases (87.3 per cent.) the operation was a complete success and effected a radical cure.
This is a high figure, and the results are very gratifying. Ionisation has thus proved a valuable ancillary
method.
At the various centres in the Council's scheme, 20,237 appointments were made for the treatment
of aural defects ; 15,543 children attended for medical examination, and operations were performed in
11,080 cases ; 11,372 children were discharged as cured. During the year, 2,366 children were operated
upon at Cyril Henry Centre, Woolwich, and were retained at the centre for two nights after the operation.
(c) (d) and (e)—The figures relating to ringworm and vision are given in table IV.
(/) Dental defects.—Under the dental scheme, 66 part-time and 5 full-time dentists are now
employed. Full particulars of the work done during the year are given in table IV. From the inauguration
of the sale of tooth brushes to elementary school children in 1918, up to 31st December, 1921, 51,582
tooth brushes were sold ; in the same period, 18,984 tubes of tooth soap were also sold.
Stammering children.—During the year arrangements were continued for remedial treatment
of stammering children. The treatment is carried out at six of the Council's schools, where use is made
of vacant rooms not required for ordinary teaching purposes. At each centre two groups of about
12 children each are dealt with twice weekly during one school session, each group receiving treatment
and advice from special instructresses in speech training. In the course of the year 330 children passed
into these centres. A number of the more chronic patients were sent to Margate and Bushy Park Camp
Schools with beneficial results.
The children are kept under medical supervision and are discharged when considered provisionally
cured or when sufficient improvement is made to render further treatment unnecessary. As early as
possible during treatment any physical defect which might aggravate the condition either directly by
affecting speech or indirectly by lowering the general health standard is remedied as far as possible.
Of the 330 children under review during the year 53 were discharged after having attended the centres
for one term, 30 after two terms, 24 after three terms, 5 after four terms, and 8 after five terms, a total
of 120 being discharged during the year.
During treatment, reports as to progress are received from teachers and parents and also at definite
intervals after discharge information is obtained as to the condition of the children. Throughout 1921
it was found necessary to arrange for 15 children to be re-admitted for further treatment as their reports
appeared to show a tendency to relapse. Of these 15, 8 recovered after further treatment extending
over one term, and 1 child after two terms ; 3 children had left school, and in 3 cases the parents declined
to let the children re-attend.
During the year some difficulty was experienced in finding enough girls to fill the girls' classes
(figures quoted in a previous report showed that there were about three times the number of boy as of girl
stammerers) and the experiment was tried of introducing into the girls' classes boy stammerers who
were attending neighbouring schools. Only boys aged 8 to 11 were thus dealt with, it having been
found at the commencement of these classes that mixed classes of older boys and girls tended to accentuate
the nervous tendency of stammering children. The experiment was found to be a decided success;
the elder girls showed a kindly interest in the younger boys and were always willing to aid them in
any difficulties which arose. From the experience thus gained it appeared that quicker and better
results are obtained the younger the subject and the less chance the stammering has of becoming stereotyped.
The number of younger children dealt with so far is too small to base separate statistics on at
present. Even when the cases are finally discharged the carrying out of the practical exercises is strongly
recommended in order that possible relapses may be prevented. Arrangements are made for these cases
at Bushy Park for half-an-hour's practice each day.
The parents are invited to attend the centres, and efforts are made to obtain information as to the
cause and mode of onset of the stammering. A note is also made as to family history. From information
obtained in respect of the children dealt with in 1921 it appears that stammering began before 7 years
in 100 cases ; stammering began after 7 years in 64 cases. Aetiology of the cases seen (i.e., causes elicited
as far as can be ascertained):—Imitation, 19 ; shock, 82; physical causes, 25 ; congenital (i.e., with
speech), 80 ; hereditary history of stammering, 53 ; bad physique, 49 ; neurotic history, 63 ; left handedness,
4.
Nursery schools.
In the whole of London there are only ten recognised nursery schools, accommodating altogether
about 500 children, from the ages of two to five. Of these the Rachel McMillan voluntary school at
Deptford accounts for 100 and the Council's new school on the adjoining site for another 100. Next
in size comes the oldest of these schools, the Notting Hill, accommodating 50 children. Children over
five are occasionally allowed, on medical grounds, to remain until six years of age; in the
case of the Jellicoe School special permission to keep children until six has been given. The schools are
all under medical supervision, and seven of them are visited daily by one of the Council's nurses, who
attends to minor ailments, watches for signs of infectious disease and helps with the general hygiene
and cleanliness of the children.
Two-year-old children, on account of their exacting physical requirements, involve the greater
amount of work, yet the proportion of these children bears no definite relation to the staff employed.
Apart from the Deptford Schools, Kilburn Union Jack and the Passmore Edwards Schools appear to
have the smallest staff and largest number of two-year-old children.
Towards the end of September the Council's new nursery school at Deptford began admitting
children, and later was officially opened by Her Majesty the Queen. This school adjoins the present
Rachel McMillan voluntary nursery school and training centre. The two schools share the same Superintendent,
Miss Stevenson, and the food comes from a kitchen common to the schools and the training
centre attached.