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123
Classes for
stammerers.
During 1925, 276 children passed through the stammering centres; of these,
70 were discharged cured, 43 were discharged provisionally cured, as they did not
stammer in the clinic. It was recognised, however, that under special stress, e.g.,
moving to a higher class, it was possible that the stammer might reappear temporarily.
From past experience of those provisionally cured, it is found that these recurrences
are increasingly small. The important point being that confidence having been
established in the class, it becomes necessary to put this new-found confidence
to the test of the every-day world, rather than they should become dependent on
the atmosphere of the clinic alone. All children discharged are followed up for
the three following terms and reports obtained as to their condition. During the
year 14 of these children were noted as having relapsed and were re-admitted to
the clinic for a further course of treatment. Of these 9 were discharged as cured
during the year, 4 were still attending at the end of the year and one child had left
school. Much depends upon the after-care of children who have been discharged
cured from the classes. Sympathy and encouragement in the environment both
at school and at home are necessary to ensure permanent results. How much this
is so is seen from the fact that at the Jews' Free School relapses after discharge have
been almost unknown.
At the Jews' Free School centre, the children are selected from this school only.
The results are extremely gratifying, and show the importance of the help and
sympathy of the headmaster and the care committee. One case of cleft palate with
very defective articulation was treated at this school, after the stammering children
had been dismissed from the class, with very beneficial results.
Further investigations have been carried out with regard to the family histories
of the stammering children. It is interesting to note that taking 109 consecutive
cases, 20 were first-born children, and in 16 cases there was a family history of lefthandedness,
although the sufferer may not have been left-handed.
Manifestations of Rheumatism in Childhood.
While no age is exempt from the incidence of rheumatism there is a special
liability to attack in the case of children of school age. In addition to the greater
incidence, it is important to note that the manifestations of rheumatism during the
school period of life assume a special character. The rheumatic infection is especially
liable at this age to involve the heart, leaving permanent disease of this organ.
Dr. Carey Coombs, of Bristol, estimates that about two-thirds of the rheumatic
heart cases in Bristol begin between the ages of 5 and 15. At the school age also
the rheumatic infection is very liable to affect the central nervous system, and chorea,
or St. Vitus' dance, is a rheumatic symptom which is practically limited to school
children.
There are two special features connected with rheumatism in children which
it is important to emphasise—(1) Instead of the onset taking the form of an acute
illness, it often commences insidiously as a general falling off in health, accompanied
by pallor, but with no active complaint other than occasional sore throat and what
are vaguely described as " growing pains." In such cases there is a special danger
of involvement of the heart. Many of these cases are often not suspected or diagnosed
until they come under inspection by the doctor at school. (2) Rheumatism differs
from most of the acute infectious fevers in that one attack confers no immunity upon
the patient. On the contrary, recurrence of the disease is very frequent, and the
liability to attack is greatly raised in those who have already suffered. There is
great danger in recurrent attacks for the heart to be especially affected.
Number of
children
suffering.
Although necessarily, in the absence of general notification of disease, it is not
possible to give accurate figures, the size of the problem can be gauged with a fair
degree of accuracy. From reports made by the school doctors it may be computed
that there are in the London area certainly not less than 10,000 children who have