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as early as possible, as there is no lower age limit for their attendance at deaf schools.
In the case of all children with hardness of hearing the question of the need for
special education should be considered at the earliest moment in addition to the
question of treatment, and the head teacher should be asked to fill up form M.O. 51
and to forward it to the school medical officer at the County Hall.
"In order that there should be no possibility of delay in obtaining consideration
for hard-of-hearing children the following rules should be carried out by the doctors
in the schools :—
(1) During re-inspections at each school the school doctor should set
apart a definite time for reviewing all children in the school who are known
or suspected to be hard of hearing.
(2) All such children should be carefully tested by the forced whisper
test. The children tested should be classified as follows :—
A.—A child who responds at 20 feet should be regarded as normal.
B.—A child who responds at distances between 6 and 20 feet should be
regarded as slightly hard of hearing—to be watched.
C.—A child who responds only at distances below 6 feet in the better ear
should be considered hard of hearing (or deaf).
The forced whisper should be made at the end of an ordinary expiration.
Numbers like ninety-seven, eighty-three, etc., or words such as 'banana,'
'potato,' 'tobacco,' may be used. The child should not be in a position to
watch the doctor's lips during the test and should be requested to repeat the
words heard.
(3) The same test should be made in the case of children found to be hard
of hearing during routine medical inspection.
(4) In every case the result of the test should be recorded on the forms
in the following way, e.g.:—
F.W. at 5 feet—H. of H.
F.W. at 10 feet—slightly H. of H.
(5) All children falling into category C above should be nominated for
special examination. The school doctor should forward the medical cards
to the Divisional Medical Officer and the head teacher should be asked to fill
up form 51 and to forward it without delay to the School Medical Officer. But
children approaching the leaving age should not be nominated unless the deafness
is very pronounced, e.g., F.W. at 4 feet or worse.
(6) All children falling into category B, should be kept under observation.
(7) In each succeeding term all the children previously found to be deaf
or hard-of-hearing should be tested, together with any children who may have
been suspected to have become hard of hearing in the meanwhile, and the
results of the test recorded.
" Any difficulties experienced in carrying out the above instructions should be
at once reported to the divisional medical officer."
In spite of the special attention directed to the detection of deafness, fewer
cases were notified as a result of medical inspection. There appears therefore to be
no ground for any apprehension that deaf or hard of hearing children fail to be
detected at medical inspections.
Enlarged
glands of the
neck.
Enlarged glands of the neck (non-tuberculous) were noted in 9,637 children
or 5"2 per cent. In 1925 the percentage was 4.78 per cent. There has been a
gradual increase during recent years in the number of children reported with enlarged
glands.
The incidence is heaviest upon entrant infants (7.3 per cent, in boys and 63
per cent, in girls) and least upon the oldest children (3.4 per cent, in boys and 3.3
per cent, in girls). Although the number of children noted to have enlarged cervical
glands has increased, the number referred for treatment shows no similar increase.